Evaluating the Effectiveness and Safety of Oral Antithrombotic Therapy in Head and Neck Cancer Patients with Radiation Therapy

• Main Authors: Chin-Wei Hsu, 許晉瑋
• Other Authors: Yaw-Bin Huang
• Format: Others
• Language: en_US
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/39896591013125277969

碩士 === 高雄醫學大學 === 藥學系臨床藥學碩士班 === 104 === Background and objective: Radiation therapy (RT) is a common and effective treatment in patients with head and neck cancer (HNC). Studies have shown that RT increases risk of ischemic stroke or transient ischemic attack (TIA) in patients with HNC. Oral antithrombotic therapy, including antiplatelets and anticoagulants, are usually used to prevent cerebrovascular events. However, no study assesses the use of oral antithrombotic therapy in this population. Our study objective is to evaluate the effectiveness and safety of oral antithrombotic therapy in HNC patients with RT. Methods: This population-based retrospective cohort study identified the cases of HNC after RT by using National Health Insurance Research Database. Cases were classified into the users of oral antithrombotic therapy and the non-users. Primary outcome was ischemic stroke or TIA. Secondary outcomes were any cause of death and major bleeding. Cox proportional hazard models were performed to calculate hazard ratio (HR) and 95% confidence interval (CI). Results: A total of 37,638 patients were included in this study. No significant decreased risk of ischemic stroke or TIA was found between users without discontinuation of oral antithrombotic therapy and non-users (adjusted HR: 0.828; 95% CI: 0.203 – 3.376), but significantly increased risk of death was seen (adjusted HR: 1.653; 95% CI: 1.054 - 2.594). No statistical significance was revealed in major bleeding. Conclusion: For HNC patients with RT, oral antithrombotic therapy does not significantly reduce the risk of ischemic stroke or TIA and significantly increase risk of major bleeding.