Vascular events in patients with head and neck cancer: A systematic review and meta-analysis

Head Neck. 2024 Jul;46(7):1557-1572. doi: 10.1002/hed.27675. Epub 2024 Feb 9.

Abstract

Objective: To assess the incidence of vascular events in patients with head and neck cancer.

Review methods: Primary studies identified through April 2023. Meta-analysis was performed.

Results: There were 146 studies included in the systematic review. Rates of events were collected in the overall group, those with chemoprophylaxis, and those that underwent surgery, radiation, or chemotherapy. Of 1 184 160 patients, 4.3% had a vascular event. Radiation therapy had highest risk of overall events and stroke when compared to surgery and chemotherapy. Chemotherapy had a higher risk of stroke and overall events when compared to surgery.

Conclusions: Vascular events occur in 4%-5% of patients with head and neck cancer. Our data does not support the use of routine anticoagulation. Patients undergoing radiation therapy had the highest frequency of events.

Keywords: head and neck cancer; hemorrhage; infarction; ischemia; thrombosis; vascular events.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Head and Neck Neoplasms* / therapy
  • Humans
  • Incidence
  • Stroke / epidemiology
  • Stroke / etiology
  • Stroke / prevention & control
  • Vascular Diseases / etiology