Low-density lipoprotein cholesterol and radiotherapy-induced carotid atherosclerosis in subjects with head and neck cancer

Abstract

BackgroundRadiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer. However, the risk factors of RT-induced carotid artery remodeling are not established. This study aimed to investigate the effects of RT on carotid and popliteal arteries in subjects with head and neck cancer and to evaluate the relationship between baseline clinical and laboratory features and the progression of RT-induced atherosclerosis.FindingsEleven men (age = 57.9 ± 6.2years) with head and neck cancer who underwent cervical bilateral irradiation were prospectively examined by clinical and laboratory analysis and by carotid and popliteal ultrasound before and after treatment (mean interval between the end of RT and the post-RT assessment = 181 ± 47 days). No studied subject used hypocholesterolemic medications. Significant increases in carotid intima-media thickness (IMT) (0.95 ± 0.08 vs. 0.87 ± 0.05 mm; p < 0.0001) and carotid IMT/diameter ratio (0.138 ± 0.013 vs. 0.129 ± 0.014; p = 0.001) were observed after RT, while no changes in popliteal structural features were detected. In addition, baseline low-density lipoprotein cholesterol levels showed a direct correlation with RT-induced carotid IMT change (r = 0.66; p = 0.027), while no other studied variable exhibited a significant relationship with carotid IMT change.ConclusionsThese results indicate that RT-induced atherosclerosis is limited to the irradiated area and also suggest that it may be predicted by low-density lipoprotein cholesterol levels in subjects with head and neck cancer.

Changes in the Common Carotid Artery after Radiotherapy: Wall Thickness, Calcification, and Atherosclerosis

“…Our findings are thus consistent with previous reports of an association between baseline cholesterol levels and increases in the intima-media thickness (IMT) or plaque scores as measured by duplex sonography. 21 …”

Cardiovascular risk and prevention in patients with head and neck cancer treated with radiotherapy

“…Additionally, future work should investigate whether statins or other drugs protect the carotid arteries from RT‐related injury. The hypothesis that statins reduce RT‐related carotid artery injury by lowering cholesterol levels is suggested by a clinical study that found that the degree of progression in carotid artery intima‐media thickness after RT was associated with pre‐RT low‐density lipoprotein cholesterol levels ( r = 0.66; p = 0.03) . If statins are found to be protective, this would lead to an expansion of the indications for statin use to include patients receiving head and neck RT with otherwise low CVD risk.…”

Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy

“…Every effort to mitigate IS occurrence and the progression of post-RT vasculopathy in HNC survivors is crucial [29]. However, in the early post-RT vasculopathy phase, few interventions had been proved effective in curbing or slowing down disease progression [30][31][32][33][34]. In our results, thyroxine supplement showed insu cient clinical bene ts on CAS progression or IS prevention in HNC patients after RT.…”