Carotici Artery Disease Following ExternalCervical Irradiation

Elerding, Steven C.; Fernandez, Robert N.; Grotta, James C.; Lindberg, Robert D.; Causay, Lucell C.; McMurtrey, Marion J.

doi:10.1097/00000658-198111000-00009

Cited by 158 publications

(83 citation statements)

References 26 publications

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“…The magnitude of a possibly increased risk of future stroke due to radiotherapy to the neck cannot be extracted from the data and cases published so far. Evidence for an increased risk of stroke was provided in a cohort study by Elerding et al, [1] but they were not able to establish a definite relation between RT on the neck and increased risk of stroke.…”

Section: Introductionmentioning

confidence: 97%

Neck Irradiation, Carotid Stenosis and Carotid Intima-Media Thickness as Stroke Predictor

Khatri¹

2013

IOSR-JDMS

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Section: Introductionmentioning

confidence: 97%

Neck Irradiation, Carotid Stenosis and Carotid Intima-Media Thickness as Stroke Predictor

Khatri¹

2013

IOSR-JDMS

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“…8 Three (60%) of our five patients presented with symptomatic disease; each had survived at least 10 years after undergoing cervical irradiation. Treatment of this group of patients often requires complex arterial reconstruction because of the extensive amounts of plaque and the difficulty involved in dissecting the plaque from the normal vessel wall.…”

Section: Discussionmentioning

confidence: 88%

Endovascular management of carotid artery disease after radiation therapy and radical neck dissection

Ecker¹,

Donovan²,

Hopkins³

2005

FOC

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Object More patients with head and neck cancers who undergo radical neck dissection and adjuvant radiation are experiencing prolonged survival times. Because of their improved survival, patients are living long enough to suffer the delayed effects of radiation therapy. Radiation-induced carotid artery (CA) stenosis in patients with or without radical neck dissection often requires extensive exposure and vessel reconstruction. The aim of this study was to evaluate the efficacy of endovascular treatment as an alternative therapy for radiation-induced CA stenosis. Methods Coinciding with the improved longevity of these patients, CA angioplasty and stent placement has become a definitive treatment strategy for this particularly challenging group of individuals. Long lesions are easily addressed with multiple telescoped stents. The tendency toward early restenosis can now be addressed with cutting balloon angioplasty. A review of the authors' institutional database yielded five patients (four men and one woman) with a history of radiation treatment ipsilateral to their CA stenosis. Three of five patients were symptomatic, and the interval between radiation therapy and endovascular treatment ranged from 1 to 47 years (mean 16.6 years). Four of the five patients were treated using distal embolic protection devices, and all patients underwent balloon dilation after stent placement. Conclusions As advancements are made in the technology and techniques for CA angioplasty and stent placement, the safety and durability of treatments in patients with radiation-induced atherosclerotic disease will improve.

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“…receive a relatively low radiation dose such as those with Hodgkin's lymphoma. 7 Although vessel injury secondary to RT has been established, threshold value of the relation between dose and injury has not been determined so far. Chung et al 8 , have compared patients receiving high dose irradiation (65 Gy) with those receiving lower doses (<60 Gy), and could not establish a dose related relationship with the intensity of carotid changes in post-irradiation MR angiography studies.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Late Radiation Side Effects in Nasopharyngeal Cancer Patients

Mayadağlı¹

2012

UHOD

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The prolongation of survival in cases with nasopharynx cancer has made quality of life after treatment more important. The aim of this study is to consider late toxicity developing after treatment in order to maintain a high quality of life. Thirty-two patients receiving radiotherapy (RT) to the neck region 1-10 years ago due to nasopharyngeal carcinoma were included in the study. Neck ultrasonography (USG), thyroid function tests and dynamic brain magnetic resonance imaging (MRI) were carried out for carotid artery stenosis, hypothyroidism, and necrosis of the temporal lobe. Obtained data were analyzed with the SPSS 11.5. Intima-media thickness of below 60 Gy and above 60 Gy doses administered to the neck were similar. Intima-media thickness was greater in patients with a period longer than 5 years after RT than with a period shorter than 5 years (p< 0.001). Intima-media thicknesses of the patients above 40 years, with high cholesterol values, a history of smoking and hypertension were higher than those without them (p< 0.001). There was hypothyroidism in five (15%) of the 32 patients. Necrosis of the temporal lobe was not seen in any of the patients. Carotid artery stenosis after treatment depends more on the duration of the period after treatment and the patient's being in the age group when atherosclerotic risk factors are present than on the amount of dose administered.Keywords: Head-neck tumor, Radiotherapy, Late toxicity, Hypothyroidism ÖZET Nazofarenks kanserli Olgularda Rdyoterapiye Sekonder Geliflen Geç Yan Etkilerin De¤erlendirilmesiSon y›llarda nazofarenks kanserli olgularda yaflam süresinin artmas›, tedavi sonras› yaflam kalitesini ön plana ç›karm›flt›r. Bu grup hastalarda yaflam kalitesini yüksek tutmak için tedavi sonras› geliflen geç toksisitelerin irdelenmesi amaçlanm›flt›r. Nazofarenks kanseri nedeniyle boyun bölgesine 1-10 y›l önce radyoterapi (RT) alan 32 hasta çal›flmaya al›nm›flt›r. Hastalar›n karotis arter stenozu, hipotiroidi ve temporal lob nekrozu için boyun ultrasonogrofi (USG), tiroid fonksiyon testi ve dinamik beyin magnetik rezonans› (MR) yap›l-m›flt›r. Elde edilen veriler SPSS 11.5'de de¤erlendirilmifltir. Boyuna uygulanan 60 Gy alt› ile 60 Gy üzeri dozlardaki karotis intima-media kal›nl›¤› benzer ç›km›flt›r. RT sonras› geçen süre 5 y›ldan fazla olan hastalarda intima-media kal›nl›¤›, 5 y›ldan az olan hastalara oranla daha yüksek saptanm›flt›r (p< 0.001). 40 yafl üstü, kolesterol de¤eri yüksek, sigara ve hipertansiyon hikayesi olan hastalar›n damar kal›nl›¤› olmayanlardan daha yüksek ç›km›flt›r (p< 0.001). 32 hastadan 5'inde (%15) hipotiroidi saptanm›flt›r. Hastalar›n hiçbi-rinde temporal lob nekrozuna rastlanmam›flt›r. Tedavi sonras› karotis arter stenozu, uygulanan dozdan çok tedavi sonras› geçen sü-reye ve hastan›n aterosklerotik risk faktörlerini tafl›yaca¤› yafl grubunda olmas›na ba¤l›d›r. Bu grup hastalar›n takip ve kontrollerinde geç toksisitenin iyi flekilde de¤erlendirilmesi, aterosklerotik risk faktörlerine yönelik önleyici tedbirlerin al›nmas› ve tedavisine yönel...

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Carotici Artery Disease Following ExternalCervical Irradiation

Cited by 158 publications

References 26 publications

Neck Irradiation, Carotid Stenosis and Carotid Intima-Media Thickness as Stroke Predictor

Neck Irradiation, Carotid Stenosis and Carotid Intima-Media Thickness as Stroke Predictor

Endovascular management of carotid artery disease after radiation therapy and radical neck dissection

Evaluation of Late Radiation Side Effects in Nasopharyngeal Cancer Patients

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