Abstract
BackgroundIntracranial aneurysms after radiotherapy (RT) have previously been reported. However, the majority of studies were case reports. Therefore, we performed a nationwide study to explore the risk of radiation-induced intracranial aneurysms.MethodsThis study included patients diagnosed with head and neck cancer (ICD9: 140–149, 161). Intracranial aneurysms formation was identified using the following ICD9 codes: nonruptured cerebral aneurysm (ICD9:4373), aneurysm clipping (ICD9:3951). Patients who did not receive curative treatment and those with intracranial aneurysms before the diagnosis of head and neck cancer were excluded.ResultsIn total, 70,691 patients were included in the final analysis; they were categorized into the following three groups: nasopharyngeal carcinoma (NPC) with RT, non-NPC with RT, and non-NPC without RT. Patients in the NPC with RT group had the highest risk of developing intracranial aneurysms (hazard ratio (HR) 2.57; P < 0.001). In addition, hypertension was also a risk factor of developing intracranial aneurysms (HR 2.14; P < 0.01). The mean time interval from cancer diagnosis to intracranial aneurysm formation in the NPC with RT group was 4.3 ± 3.1 years.ConclusionsCompared with the non-NPC with RT and the non-NPC without RT groups, patients with NPC who received RT had a higher risk of developing intracranial aneurysms.
Highlights
Intracranial aneurysms after radiotherapy (RT) have previously been reported
We aimed to evaluate the risk of intracranial aneurysmal development in patients with head and neck cancer
40 nasopharyngeal carcinoma (NPC)-RT cases were diagnosed with intracranial aneurysms after RT
Summary
Intracranial aneurysms after radiotherapy (RT) have previously been reported. the majority of studies were case reports. The average life expectancy of cancer patients has increased, owing in large part to the increase in the application of radiotherapy (RT) and improvements in healthcare. With this increase in lifespan, the long-term effects of RT have become more important. In 2000, Maruyama et al performed a literature review that included both radiation-induced aneurysms and moyamoya vessels [23]. They concluded that radiationinduced vasculopathy was rare, but that it may be fatal. Their study had several limitations, including a limited number of cases, inconsistent diagnostic criteria, and a lack of reliable histologic and radiographic characteristics to establish a statistical model
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