Predictors of carotid artery stenosis after radiotherapy for head and neck cancers

Chang, Yu‐Cheng; Chang, Tung-Chieh; Lee, Tsong‐Hai; Ryu, Shan‐Jin

doi:10.1016/j.jvs.2009.01.033

Cited by 80 publications

(100 citation statements)

References 17 publications

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“…A possible explanation for the higher risk may be the differences in radiation doses, which were confirmed by Chang et al [18]. In conclusion, RT in addition to other traditional risk factors has a combined effect on the progression of postradiation atherosclerosis.…”

Section: Risk Factorsmentioning

confidence: 65%

“…Lam et al [2] found that age and irradiation were important factors in the development of carotid stenosis. Chang et al [18] showed a positive correlation between the total plaque score, which is an index of atherosclerosis, RT use, RT dose, length of time after RT, hyperlipidemia, and age. The study of Cheng et al [3] revealed that severe post-RT carotid stenosis was associated with age, smoking, heart disease, no prior oncological surgery, cerebrovascular symptoms and interval from RT.…”

Section: Risk Factorsmentioning

confidence: 99%

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Radiation-Induced Carotid Artery Stenosis: A Comprehensive Review of the Literature

Cao

2013

Intervent Neurol

101

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In recent decades, with the improvement of radiotherapy (RT) technology and comprehensive treatment, the survival rate of head and neck malignancies has gained remarkable progress. Vascular injury and subsequent carotid stenosis following RT, as the backbone of treatment, have received increasing attention. Many investigations have demonstrated that radiation can result in the increase in carotid intima-media thickness, carotid stenosis and consequently lead to a higher risk of cerebrovascular events such as transient ischemic attack and stroke. In this review, we will examine the incidence of radiation-induced carotid artery stenosis, its morphological and histological characteristics, as well as its pathogenesis. The treatment and prevention methods, including follow-up strategies, will also be discussed at the end of the present review.

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Section: Risk Factorsmentioning

confidence: 65%

Section: Risk Factorsmentioning

confidence: 99%

Radiation-Induced Carotid Artery Stenosis: A Comprehensive Review of the Literature

Cao

2013

Intervent Neurol

101

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“…42 Whereas the earlier study is 1 of the largest of its kind to date, XRT protocol data are missing, sonographic interpretation was not blinded, and patients were only "asked" about previous possible CVEs. Despite this, a similarly sized study by Chang et al (290 patients) 34 lends weight to the results. Head and neck cancer patients were consecutively recruited (198 after XRT, 92 before XRT).…”

Section: Head and Neck Xrtmentioning

confidence: 88%

Ischemic Stroke and Transient Ischemic Attack After Head and Neck Radiotherapy

Plummer

Henderson

O’Sullivan

et al. 2011

Stroke

227

180

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Background and Purpose-Cerebrovascular disease can complicate head and neck radiotherapy and result in transient ischemic attack and ischemic stroke. Although the incidence of radiation vasculopathy is predicted to rise with improvements in median cancer survival, the pathogenesis, natural history, and management of the disease are ill defined. Methods-We examined studies on the epidemiology, imaging, pathogenesis, and management of medium-and large-artery intra-and extra-cranial disease after head and neck radiotherapy. Controlled prospective trials and larger retrospective trials from the last 30 years were prioritized. Results-The relative risk of transient ischemic attack or ischemic stroke is at least doubled by head and neck radiotherapy.Chronic radiation vasculopathy affecting medium and large intra-and extra-cranial arteries is characterized by increasing rates of hemodynamically significant stenosis with time from radiotherapy. Disease expression is the likely consequence of the combined radiation insult to the intima-media (accelerating atherosclerosis) and to the adventitia (injuring the vasa vasorum). Optimal medical treatment is not established. Carotid endarterectomy is confounded by the need to operate across scarred tissue planes, whereas carotid stenting procedures have resulted in high restenosis rates. Conclusions-Head and neck radiotherapy significantly increases the risk of transient ischemic attack and ischemic stroke.Evidence-based guidelines for the management of asymptomatic and symptomatic (medium-and large-artery) radiation vasculopathy are lacking. Long-term prospective studies remain a priority, as the incidence of the problem is anticipated to rise with improvements in postradiotherapy patient survival. (Stroke. 2011;42:2410-2418.)

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“…Après irradiation du cou, le taux de sténose carotidienne supérieure à 50 % est de 20 %. L'âge inférieur à 50 ans est le principal facteur pronostique défavorable [53]. Un contrôle vasculaire est justifié chez ces patients.…”

Section: Autre Toxicité Radio-induiteunclassified

Suivi clinique et paraclinique après radiothérapie pour un cancer des voies aérodigestives supérieures

Clément-Colmou

Troussier

Bardet

et al. 2015

Cancer/Radiothérapie

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Predictors of carotid artery stenosis after radiotherapy for head and neck cancers

Abstract: In head and neck cancer, the high post-treatment incidence of radiation-induced CAS indicates the importance of regular examination of the carotid duplex and early antiplatelet prophylaxis. Different age groups may require different irradiation strategies to prevent radiation-induced CAS.

Cited by 80 publications

References 17 publications

Radiation-Induced Carotid Artery Stenosis: A Comprehensive Review of the Literature

Radiation-Induced Carotid Artery Stenosis: A Comprehensive Review of the Literature

Ischemic Stroke and Transient Ischemic Attack After Head and Neck Radiotherapy

Suivi clinique et paraclinique après radiothérapie pour un cancer des voies aérodigestives supérieures

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