Risk of ocular complications following radiation therapy in head and neck cancer patients: A nationwide retrospective population-based cohort study

頭頸癌病患接受放射治療產生眼睛併發症的風險：台灣健保資料庫研究

曹志鉦(Chih-Cheng Tsao) ； 劉珉玥(Ming-Yueh Liu) ； 羅承翔(Cheng-Hsiang Lo) ； 范兆岳(Chao-Yueh Fan) ； 黃文彥(Wen-Yen Huang) ； 趙興隆(Hsin-Lung Chao) ； 陳昌明(Chang-Ming Chen) ； 楊仁富(Jen-Fu Yang) ； 沈伯鍵(Po-Chien Shen) ； 林昆澤(Kuen-Tze Lin) ； 林群書(Chun-Shu Lin)

《放射治療與腫瘤學》 24卷3期 (2017/09) Pp. 197-205

https://doi.org/10.6316/TRO/201724(3)197

摘要

Purpose : To examine the risk of ocular complications following radiotherapy in head and neck cancer patients. Materials and Methods : We identified a radiotherapy cohort (n= 2,733) and a control cohort (n= 375) in the National Health Insurance Research Database from 1997 to 2010. The follow-up period was terminated upon developing ocular complications (ICD-9-CM 361, 362, 363, 365, 366) or on December 31, 2010. Results : After adjusting for the confounding factors of the study, the radiotherapy cohort had a higher adjusted hazard ratio (HR; 2.451, 95% CI = 1.087－6.895) of developing ocular complications than did the control cohort. The radiotherapy cohort was associated with a significantly higher risk of developing ocular complications compared with the control cohort when the follow-up period was longer than 36 months (adjusted HR = 2.581, 95% CI = 1.256－5.493). Primary head and neck tumors are mostly located in the nasopharynx and oral cavity. The most common associated ocular complications were retinopathy and cataracts. Conclusions : Patients who receive radiotherapy for head and neck cancer might be at higher risk for developing ocular complications in Taiwan. Radiation oncologists should pay more attention to this association.

關鍵字

Ocular complications ； Radiation therapy ； Head and neck cancer ； National Health Insurance Research Database

並列摘要

目的：探討頭頸癌病患接受放射治療產生眼睛併發症的風險。材料與方法：本研究從 1997 年至 2010 年自台灣健保資料庫中，找出頭頸癌接受放射治療病人共 2,733 位，未接受放射治療病人共 375 位。追蹤停止時間為發生眼睛併發症（白內障、青光眼、視網膜病變）或 2010 年 12 月 31 日。結果：校正可能影響結果的因子後，頭頸癌接受放射治療病人比未接受放射治療病人產生眼睛併發症的風險為 2.45 倍（HR; 2.451, 95% CI = 1.087－6.895）。當追蹤時間超過 36 個月，頭頸癌接受放射治療病人比未接受放射治療病人產生眼睛併發症的風險為 2.581 倍（adjusted HR =2.581, 95% CI = 1.256－5.493）。頭頸癌原發部位以鼻咽癌和口腔癌居多；產生的眼睛併發症以視網膜病變和白內障居多。結論：在台灣的頭頸癌病人，放射治療與之後產生的眼睛併發症兩者有相關聯性；放射腫瘤科醫師對此相關聯性要提高警覺。

並列關鍵字

眼睛併發症 ； 放射治療 ； 頭頸癌 ； 健保資料庫