Intimal–medial thickness and carotid arteries lumen in irradiated patients for head and neck cancer: preliminary data of an observational study

Clinical and Translational Oncology - Tập 15 - Trang 861-864 - 2013
M. Faruolo1, A. Fiorentino2, G. Gallucci1, L. Lapadula2, V. Fusco2
1Cardiology Service, IRCCS/CROB, Rionero in Vulture (PZ), Italy
2Department of Radiation Oncology, IRCCS/CROB, Rionero in Vulture, PZ, Italy

Tóm tắt

To investigate the effect of external beam radiotherapy (EBRT) for head and neck cancer (HNC) the intimal–medial thickness (IMT) and the lumen of the carotid artery. Patients with HNC and an indication for EBRT were enrolled. A carotid artery color Doppler examination was performed before and 6 and 12 months after EBRT. From 2008 to 2011, 50 patients were enrolled. The mean carotid IMT was 0.9 vs. 1.02 mm before and 6 months after EBRT, respectively (p = 0.0001). The common carotid artery lumen was narrowed without statistical significance, 6 months after EBRT (p = 0.3). 1 year from EBRT, the IMT increase and the lumen reduction were statistically significant (p = 0.001, p = 0.01, respectively). Neurological events (stroke or TIA) were not observed. Our data showed a significant IMT increase 6 months from EBRT without a corresponding narrowing of the common carotid lumen while a significant increase 12 months after EBRT.

Tài liệu tham khảo

Carmody BJ, Arora S, Avena R, Curry KM, Simpkins J, Cosby K, et al. Accelerated carotid artery disease after high-dose head and neck radiotherapy: is there a role for routine carotid duplex surveillance? J Vasc Surg. 1999;30:1045–51. Cheng SW, Wu LL, Ting AC, Lau H, Lam LK, Wei WI. Irradiation-induced extracranial carotid stenosis in patients with head and neck malignancies. Am J Surg. 1999;178:323–8. Cheng SWK, Ting ACW, Wu LLH. Accelerated progression of carotid stenosis in patients with previous external neck irradiation. J Vasc Surg. 2004;39:409–15. Chang YJ, Chang TC, Lee TC, Ryu SJ. Predictors of carotid artery stenosis after radiotherapy for head and neck cancers. J Vasc Surg. 2009;50:280–5. Cheng SWK, Ting ACW, Wu LLH. Ultrasonic analysis of plaque characteristics and intimal–medial thickness in radiation-induced atherosclerosis carotid artery. Eur J Endovasc Surg. 2002;24:499–504. Fajardo LF. Is the pathology of radiation injury different in small vs large blood vessel? Cardiovasc Radiat Med. 1999;1:108–10. Pedicini P, Caivano R, Jereczek-Fossa BA, Strigari L, Vischioni B, Alterio D, et al. Modelling the correlation between EGFr expression and tumour cell radiosensitivity, and combined treatments of radiation and monoclonal antibody EGFr inhibitors. Theor Biol Med Model. 2012;9:37. Bonner JA, Harari PM, Giralt J, Cohen RB, Jones CU, Sur RK, et al. Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase III randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol. 2010;11:21–8. Dorresteijn LDA, Kappelle AC, Boogerd W, Klokman WJ, Balm AJ, Keus RB, et al. Increased risk of ischemic stroke after radiotherapy on the neck in patients younger than 60 years. J Clin Oncol. 2002;20:282–8. Li CS, Schminke U. Tan TY Extracranial carotid artery disease in nasopharyngeal carcinoma patients with post-irradiation ischemic stroke. Clin Neurol Neurosurg. 2010;112:865–8. Stewart FA, Hoving S, Russel NS. Vascular damage as an underlying mechanism of cardiac and cerebral toxicity in irradiated cancer patients. Radiation Res. 2010;174:865–9. Gianicolo ME, Gianicolo EA, Tramacere F, Andrenassi MG, Portaluri M. Effects of external irradiation of the neck region on intima media thickness of the common carotid artery. Cardiovasc Ultrasound. 2010;8:8. Nordstrom CK, Dwyer KM, Merz NB, Shircore A, Dwyer JH. Leisure time physical activity and early atherosclerosis: the Los Angeles atherosclerosis study. Am J Med. 2003;115:19–25. Muzzafar K, Collins SL, Labropoulos N, Baker WH. A prospective study of the effects of irradiation on the carotid artery. Laryngoscope. 2000;111:1811–4. O’leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med. 1999;340:14–22. Elerding SC, Fernandez RN, Grotta JC, Lindberg RD, Causay LC, McMurtrey MJ. Carotid artery disease following external cervical irradiation. Ann Surg. 1981;194:609–15. Cheng SW, Ting AC, Lam LK, Wei WI. Carotid stenosis after radiotherapy for nasopharyngeal carcinoma. Act Otolaryngol Head Neck Surg. 2000;126:517–21. Lam WW, Leung SF, So NM, Wong KS, Liu KH, Ku PK, et al. Incidence of carotid stenosis in nasopharyngeal carcinoma patients after radiotherapy. Cancer. 2001;92:2357–63. Fiorentino A, Cozzolino M, Caivano R, Pedicini P, Chiumento C, Oliviero C, et al. Cone-beam computed tomography dose monitoring during intensity-modulated radiotherapy in head and neck cancer: parotid glands. Clin Transl Oncol. 2012;. doi:10.1007/s1209401209464. Fiorentino A, Caivano R, Metallo V, Chiumento C, Cozzolino M, Califano G, et al. Parotid gland volumetric changes during intensity-modulated radiotherapy in head and neck cancer. Br J Radiol. 2012;85:1415–9.