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

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.