Are Hodgkin and non-Hodgkin patients at a greater risk of atherosclerosis? A follow-up of 3 years

Bilora, Franca; Pietrogrande, F; Campagnolo, Enrico; Rossato, Alberto; Polato, G; Pomerri, Fabio; Muzzio, Pier Carlo

doi:10.1111/j.1365-2354.2008.01048.x

Cited by 13 publications

(6 citation statements)

References 12 publications

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“…Also, Graus et al proposed that, the minimal dose for RT induced damage of the cervical arteries was assumed to be 41 Gy [16]. Bilora et al showed increased IMT of the arterial wall in Hodgkin and non-Hodgkin patients received RT compared to matched controls [17] [18]. Gianocolo et al confirmed these findings on 19 patients received neck irradiation and most of them had Hodgkin disease.…”

Section: Discussionsupporting

confidence: 71%

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Abdulmoniem¹,

Bayoumi²,

Asiri³

et al. 2014

JCT

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Background: The risk of carotid vessel stenosis is high after radiotherapy (RT) to neck; however, carotid vessels are unavoidable during supraclavicular (SC-RT) in adjuvant treatment of breast cancer (BC). However, carotid vessels RT dose is less well-understood. We aimed to determine the carotid vessels doses received by different techniques for SC-RT. Materials and Methods: Thirty consecutive BC patients were planned to receive SC-RT and breast after breast conserving surgery (BCS) after taking 5 mm image slices on computed tomography (CT) simulation. Organs at risk (OAR) including carotid vessels, lungs, spinal cord alongwith clinical target volume (CTV) for primary tumor and lymph nodes were delineated. Comparative analysis was done between two treatment plans; three-field conformal radiation therapy (3F-CRT) and four-field conformal RT (4F-CRT) for CTV and carotid vessels doses. Results: The 4F-CRT was found better than 3F-3DCRT regarding coverage and homogeneity of the CTV volume. The 98% of the CTV was covered by 84% dose in 3F-CRT and 95% in 4F-CRT (p 0.001). The carotid vessels maximum dose in the in 3F-CRT was 54.5 ± 1.3 Gy compared to 51.6 ± 1.3 Gy in 4F-CRT (p 0.014), however the mean dose did not differ significantly (p value 0.8). The ipsilateral lung dose did not differ between the two techniques (p Value 0.9). Conclusion: The 4F-CRT plan was found better than 3F-CRT in CTV coverage with minimal dose to the carotid vessel and without significant higher dose to the ipsilateral lung. KeywordsBreast Cancer; Supraclavicular Radiotherapy; Carotid Vessel Dose R. Abdulmoniem et al. 239

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Section: Discussionsupporting

confidence: 71%

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Abdulmoniem¹,

Bayoumi²,

Asiri³

et al. 2014

JCT

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“…Recently, irradiation of the neck has been associated with subsequent vascular wall thickening [18], accelerated atherosclerotic plaque formation [19], decreased flow on ultrasound [20], and coronary artery stenosis [21]. A recent study found that irradiation of the neck of Hodgkin (H) and non-Hodgkin (NH) patients determines a greater IMT of the arterial wall than in controls matched for the classic atherosclerosis risk factors, so authors concluded that radiotherapy can influence the atherosclerotic process [22,23]. …”

Section: Discussionmentioning

confidence: 99%

Effects of external irradiation of the neck region on intima media thickness of the common carotid artery

Gianicolo¹,

Gianicolo

Tramacere

et al. 2010

Cardiovasc Ultrasound

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BackgroundSeveral studies have shown that common carotid intima-media thickness (IMT) is increased after radiotherapy (RT) to the head and neck. However, further studies are needed to define the exact mechanism of radiation-induced injury in large vessels, investigate the relationship between radiation dose and large vessel injury and evaluate the rate of progress of atherosclerosis in irradiated vessels.ObjectivesTo investigate whether external irradiation to the carotid area has any effect on IMT of the common carotid artery in a group of patients who received RT vs control group matched for age, gender and race.MethodsWe studied 19 patients (10 male; 47.8 ± 17.4 years) during a 5-month period (January 2009-July 2009); they had completed RT with a mean of 2.9 years before (range: 1 month-6 years) The mean radiation dose to the neck in the irradiated patients was 41.2 ± 15.6 Gy (range: 25-70 Gy). Common carotid IMT was measured with echo-color Doppler. Nineteen healthy adult patients (10 male; 47.8 ± 17.6) were recruited as a control group.ResultsIMT was not significantly higher in patients when compared to the control group (0.59 ± 0.16 vs 0.56 ± 0.16 mm, p = 0.4). There was no significant difference between the two groups in relation to the absence (p = 0.7) or presence (p = 0.6) of vascular risk factors. Although the difference did not reach statistical significance (p = 0.1), the irradiated young patients (age ≤ 52 years) had IMT measurements higher (0.54 ± 0.08 mm) than the non-irradiated young patients (0.49 ± 0.14 mm). The mean carotid IMT increased with increasing doses of radiation to the neck (p = 0.04).ConclusionThis study shows that increased IMT of the common carotid artery after RT is radiation-dose-related. Therefore it is important to monitor IMT, which can be used as an imaging biomarker for early diagnosis of cerebrovascular disease in patients who have had radiotherapy for treatment of cancer of the head and neck and who are at increased risk for accelerated atherosclerosis in carotid arteries.

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“…During a 3-year followup, it was noted that despite improvement in intima-media thickens at 3 years, there was persistently reduced flow-mediated dilatation in the irradiated carotid artery, suggesting that early endothelial damage persists [47]. Radiation-induced carotid disease differs from traditional carotid disease.…”

Section: Radiation-induced Carotid Artery Diseasementioning

confidence: 99%

Radiation-Induced Heart Disease: A Clinical Update

Yusuf

Sami

Daher

2011

Cardiology Research and Practice

171

122

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Cardiovascular diseases and cancer are the two leading causes of morbidity and mortality worldwide. Improvement in cancer therapy has led to increasing number of cancer survivors, some of whom may suffer from adverse cardiovascular effects of radiation therapy. Longterm followup is essential, as the cardiac complication may manifest years after completion of radiation therapy. In this paper, we have discussed the cardiovascular effects of radiation therapy.

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Are Hodgkin and non-Hodgkin patients at a greater risk of atherosclerosis? A follow-up of 3 years

Cited by 13 publications

References 12 publications

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Effects of external irradiation of the neck region on intima media thickness of the common carotid artery

Radiation-Induced Heart Disease: A Clinical Update

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