Abstract TP194: Radiation And Stroke Death Risk In Diffuse Large B-cell Lymphoma Patients, A Population Based Study
| Autor: | Jeffrey S Baek, Sean S Szeja |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Stroke. 53 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Objective: Radiation (RT) is associated with vascular changes, which carotid studies have linked with stroke risk. Previous studies have reported an increased risk of stroke following RT for squamous cancers of head & neck (HN), or Hodgkin’s lymphomas, though with variations in dose and anatomical radiation targets. Hence the effects of low dose radiation to only the HN remains unclear. We used a national database with long-term follow up to quantify the association of RT and stroke death (SD) in patients with diffuse large B cell lymphoma (DLBCL) of the HN. Materials/Methods: Patients 30 or older with DLBCL, stage I-II of a known primary site besides CNS or mediastinum from 1983-2013 were obtained for analysis from the SEER database. Cause of death coding was filtered for Cerebrovascular Disease. Chi square, T-test, and Kaplan-Meier analysis were performed with log-rank test and Cox accounting for age, sex, RT, and year of diagnosis. Results: 33945 patients met inclusion criteria with a median follow up of 44 months. SD occurred in 410 patients in median time 62 months. RT was given in 3855 of 8312 (46%) HN and 7686 of 25633 (30%) of non-HN patients. The 10 year-SD rate was 2.2 / 2.8 % (p=0.77) for HN receiving/ not receiving RT (noRT), and 1.8 / 2.1 % for non-HN patients (p=0.40). When combining both RT and noRT patients, HN patients did show a trend towards higher SD risk compared with non-HN patients, 2.5 vs 2.0%, (p=0.053), though this did not appear to be driven by RT. On univariate analysis of HN patients, there was no difference in the effects of RT on the SD rate in any subgroup. Multivariate analysis did not identify any increased risk of SD associated with RT, either (HR = 0.87, p=0.63). Conclusions: This study did not identify any increased risk of stroke death from RT in patients with early stage DLBCL of the head & neck, although there was a trend suggesting stroke rates may be higher in patients with disease located in head & neck compared to other sites regardless of whether they received RT. Higher chemotherapy doses for non-RT patients may be a relevant confounding variable. Confirmation with pooled analyses and meta-analysis may be useful. |
| Databáze: | OpenAIRE |
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