- Among oncology patients, chemotherapy is not a significant risk factor for stroke after adjustment for cancer site and stage.
Why this matters
- Better understanding of chemotherapy-related stroke risk could inform targeted intervention.
- 31% of the cohort had chemotherapy listed in the initial treatment plan.
- By type:
- 91% cytotoxic agents,
- 14% monoclonal antibodies, and
- 5.8% tyrosine kinase inhibitors.
- Stroke incidence within 2 years of diagnosis:
- 0.75% with chemotherapy and
- 0.39% without chemotherapy.
- Stroke risk with vs without chemotherapy (HRs; 95% CIs):
- In Kaplan-Meier analysis: 1.84 (1.23-2.75).
- After adjustment for cancer site, extent (advanced vs nonadvanced): 1.20 (0.76-1.91).
- In stratified Cox regression model: 1.26 (0.78-2.03).
- Findings similar for patients confirmed to receive chemotherapy, for platinum-based chemotherapy alone.
- Japanese retrospective cohort study using hospital-based cancer registry data for 2007-2015.
- 19,006 adult patients with cancer at any site (12.9% breast; 10.9% uterine; 8.9% gastric; 7.8% prostate; 7.8% colorectal; 7.3% lung), any stage.
- Main outcome: stroke.
- Funding: Kakenhi (Grants-in-Aid for Scientific Research) of the Japan Society for the Promotion of Science.
- Analyses only for chemotherapy overall, platinum agents.
- Duration of risk elevation unclear.
- Possible misclassification.
- Potential unmeasured confounding.
- Unknown generalizability.