ArticlePloS one2021
Incidence and time trends of herpes zoster among patients with head and neck cancer who did and did not undergo radiotherapy: A population-based cohort study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Exploring the Potential Stimuli and Deterrents of Varicella-Zoster Viral Reactivation: A Scoping Review.Cureus · 2025Review
- Radiation-Associated Herpes Zoster: A Clinical Case.Cureus · 2024Article
- Associations of head and neck cancers with herpes zoster in the preceding five years.Scientific reports · 2024Article
- Review
- Radiotherapy Increases the Incidence of Herpes Zoster in Oral Cavity Cancer Patients - a National Population-based Cohort Study.In vivo (Athens, Greece)Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to determine the risk and time trends of herpes zoster among patients with head and neck cancer, with or without radiotherapy.
methodsA total of 2160 patients with head and neck cancer were enrolled. The radiotherapy and non- radiotherapy cohorts were frequency-matched at a 1:1 ratio according to sex, age, and index date. Moreover, 1080 matched non-cancer individuals were considered normal controls. Data were obtained from the National Health Insurance Research Database and Cancer Registry. The primary end point was the incidence of herpes zoster, and the adjusted confounding factors were age, sex, comorbidities, oncological surgery, and chemotherapy.
resultsThe incidence of herpes zoster was higher in cancer patients than in non-cancer individuals but did not significantly differ (13.67 vs. 8.06 per 1,000 person-years, p = 0.18). The risk of herpes zoster was significantly higher in the radiotherapy cohort than in the non-radiotherapy cohort (18.55 vs. 9.06 per 1,000 person-years, p = 0.03). The 5-year incidence rates in the radiotherapy and non-radiotherapy cohorts were 8.9% and 5%, respectively (p < 0.0001). Survival analysis indicated there was no immortal time bias. The time trends in the radiotherapy cohort persistently showed a high risk within the first 2 years, which decreased thereafter. Only patients with comorbid rheumatoid arthritis showed a significantly high risk of herpes zoster (p = 0.02). Oncological surgery and chemotherapy had no impact on the development of herpes zoster.
conclusionsThis nationwide population-based study showed that patients with head and neck cancer receiving radiotherapy are at an increased risk of herpes zoster. Health care professionals should pay more attention to this vulnerable group to improve their quality of life.
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