Radiation-Induced Vascular Disease—A State-of-the-Art Review

Yang, Eric H.; Marmagkiolis, Konstantinos; Balanescu, Dinu Valentin; Hakeem, Abdul; Donisan, Teodora; Finch, William; Virmani, Renu; Herrman, Joerg; Çilingiroğlu, Mehmet; Grines, Cindy L.; Toutouzas, Konstantinos; Iliescu, Cezar

doi:10.3389/fcvm.2021.652761

Cited by 42 publications

(42 citation statements)

References 129 publications

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“…Among these patients, 15% (17/115) had coronary artery disease and 9% (10/115) had carotid artery disease ( 35 ). A high prevalence of cardiovascular disease risk factors at HNC diagnosis requires personalized lifestyle changes and risk factor modifications to achieve LDL, blood pressure and blood sugar targets as early as possible ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Lin

Cheng²,

Hsu³

et al. 2022

Front. Oncol.

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BackgroundThe relative risk for cerebrovascular disease (CVD) is increased in patients with head and neck cancer (HNC) treated with radiotherapy (RT). However, the current relative risk for CVD following RT has not been well clarified. The purpose of this study was to analyze the effect of RT and update the risk of CVD following RT in HNC patients through a systematic review and meta-analysis.Material and MethodsWe conducted an online database search and systematic review of observational studies that reported on CVD and extracranial carotid stenosis in patients with HNC who had undergone RT. Articles published in Medline and PubMed from 1980 to 2021 were identified and collected.ResultsOf the forty-seven articles identified from PubMed and forty-four articles identified from 3 systematic reviews, twenty-two studies were included. We found that neck RT was a significant risk factor for CVD (HR 3.97, 95% CI: 2.89-5.45). Patients with HNC treated by RT had an increased OR (7.36, 95% CI: 4.13-13.11) for CVD, and approximately 26% (95% CI: 22%-31%) of HNC patients treated with RT were at risk for CVD with more than 50% reduction in carotid diameter.ConclusionThe risk of CVD is increased in patients with HNC treated by RT, and recent improvements in RT techniques may have contributed to the decreased risk of CVD. These results suggest that regular follow-up and appropriate screening for CVD should be required for patients with HNC.

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Section: Discussionmentioning

confidence: 99%

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Lin

Cheng²,

Hsu³

et al. 2022

Front. Oncol.

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“…At low doses, the damage was lessened by the activation of detoxification mechanisms, repair and turnover of damaged molecules, or through an increase in the cell proliferation that replaces irreparable or apoptotic cells. High doses were associated with irreversible damages [ 69 ]. Alterations in collagen synthesis by dysfunctional mesenchymal stem cells (MSCs) were linked to T cell large granular lymphocyte leukemia pathophysiology [ 70 ] and many preclinical animal studies showed that MSCs can enhance regeneration of tissues and accelerate angiogenesis and re-epithelialization [ 71 ], potentially via synthesis of extracellular vesicles [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Transcriptomics of Wet Skin Biopsies Predict Early Radiation-Induced Hematological Damage in a Mouse Model

Alkhalil

Clifford

Miller

et al. 2022

Genes

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The lack of an easy and fast radiation-exposure testing method with a dosimetric ability complicates triage and treatment in response to a nuclear detonation, radioactive material release, or clandestine exposure. The potential of transcriptomics in radiation diagnosis and prognosis were assessed here using wet skin (blood/skin) biopsies obtained at hour 2 and days 4, 7, 21, and 28 from a mouse radiation model. Analysis of significantly differentially transcribed genes (SDTG; p ≤ 0.05 and FC ≥ 2) during the first post-exposure week identified the glycoprotein 6 (GP-VI) signaling, the dendritic cell maturation, and the intrinsic prothrombin activation pathways as the top modulated pathways with stable inactivation after lethal exposures (20 Gy) and intermittent activation after sublethal (1, 3, 6 Gy) exposure time points (TPs). Interestingly, these pathways were inactivated in the late TPs after sublethal exposure in concordance with a delayed deleterious effect. Modulated transcription of a variety of collagen types, laminin, and peptidase genes underlay the modulated functions of these hematologically important pathways. Several other SDTGs related to platelet and leukocyte development and functions were identified. These results outlined genetic determinants that were crucial to clinically documented radiation-induced hematological and skin damage with potential countermeasure applications.

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“…Therefore, normal tissues are usually exposed or affected by RT, followed by induction of DNA damage, inflammatory responses and oxidative stress, leading to toxicity. This accounts for acute and long-term adverse effects seen with radiation treatment (4,38,39).…”

Section: Pathogenesismentioning

confidence: 99%

“…Accumulated evidence suggests that radiation-induced cardiovascular toxicity is a result of various mechanisms interacting with each other through multiple complex signaling pathways (4,38,39). Radiobiology research reveals that normal tissue injury is a dynamic and progressive process (59).…”

Section: Development Of Cardiovascular Toxicity After Rtmentioning

confidence: 99%

The risk of cardiovascular toxicity caused by cancer radiotherapy—a narrative review

Liu¹,

Fu²,

Liu³

et al. 2022

Ther Radiol Oncol

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Background and Objective: Radiotherapy is an efficient treatment for cancer. However, some cancer survivors who receive thoracic radiotherapy experience radiation-induced cardiovascular toxicity, leading to long-term impact on cardiovascular health. This review summarizes the current literature regarding the basic pathogenic mechanisms, development, and prevention of radiation-induced cardiovascular toxicity.Methods: A literature search was performed on PubMed to find reported histological observations and studies on acute and late cardiovascular toxicity in cancer patients treated with radiotherapy. A systematized review of articles on the present topic published between May 1967 and April 2021 was carried out.

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Radiation-Induced Vascular Disease—A State-of-the-Art Review

Cited by 42 publications

References 129 publications

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Risk of CVD Following Radiotherapy for Head and Neck Cancer: An Updated Systematic Review and Meta-Analysis

Transcriptomics of Wet Skin Biopsies Predict Early Radiation-Induced Hematological Damage in a Mouse Model

The risk of cardiovascular toxicity caused by cancer radiotherapy—a narrative review

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