Key result
External beam radiation linked to ~75% higher 15-year fatal CVA risk vs surgery in glottic cancer.
Cohort
Yes
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BACKGROUND: This study compared the risk of fatal cerebrovascular accidents (CVAs) in patients with early-stage glottic laryngeal cancer receiving surgery or external beam radiation therapy (EBRT). METHODS: Using a competing risks survival analysis, we compared the risk of death because of CVA among patients with early-stage glottic laryngeal cancer receiving surgery or EBRT in the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS: The cumulative incidence of fatal CVA at 15 years was higher in patients receiving EBRT (2.8%; 95% confidence interval [CI], 2.3% to 3.4%) compared to surgery (1.5%; 95% CI, 0.8% to 2.3%; p = .024). In multivariable competing risks regression models, EBRT remained associated with an increased risk of fatal CVA compared to surgery (adjusted hazard ratio [HR], 1.75; 95% CI, 1.04-2.96; p = .037). CONCLUSION: Treatment for early-stage glottic laryngeal cancer with EBRT was associated with a small increase in the risk of late fatal CVA events relative to surgery.
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Swisher‐McClure et al. (2013) conducted a cohort in Early-stage glottic laryngeal cancer. External beam radiation therapy (EBRT) vs. Surgery was evaluated on Fatal cerebrovascular accident (CVA) (HR 1.75, 95% CI 1.04-2.96, p=0.037). External beam radiation therapy for early-stage glottic laryngeal cancer increased 15-year fatal CVA risk vs surgery (2.8% vs 1.5%; adjusted HR 1.75, 95% CI 1.04-2.96; p=0.037).
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