Key result
Childhood neck radiotherapy linked to increased long-term carotid arterial stiffness vs. healthy controls.
Why the study?
It remained unclear whether vascular modifications induced by the treatment of Hodgkin lymphoma during childhood persist over the long term.
Does neck radiotherapy in childhood increase long-term arterial stiffness and endothelial dysfunction in survivors of Hodgkin lymphoma?
Case-Control (n=136)
Does neck radiotherapy in childhood increase long-term arterial stiffness and endothelial dysfunction in survivors of Hodgkin lymphoma?
Neck radiotherapy in childhood Hodgkin lymphoma survivors induces long-term vascular changes, specifically increased arterial stiffness, highlighting the need for routine ultrasound monitoring.
May warrant vascular surveillance in survivors; leaves open whether screening improves outcomes in prospective studies.
Introduction: Survivors of Hodgkin lymphoma are recognized to have an increased risk of stroke and carotid artery disease owing to neck irradiation (RT). However, it remains unclear whether the vascular modifications induced by the treatment of Hodgkin lymphoma during childhood persist over the long term. Methods: Our matched study involved 79 survivors of Hodgkin lymphoma in childhood who received neck RT and 57 healthy controls. Parameters of arterial stiffness (AS), intima-media thickness (IMT), and flow-mediated dilation (FMD) of carotid arteries were assessed using ultrasound. Results: Our patient cohort demonstrated a significant increase in AS compared to controls (p < 0.05), though no such disparity was observed for FMD (p = 0.111). Neck RT intensified AS (B = 0.037, p = 0.000), while anthracyclines attenuated it (B = −0.803, p = 0.000). Multivariate analysis revealed a positive correlation between neck RT (p < 0.001) and AS. However, we found no significant association between neck RT and FMD (p = 0.277). We identified a substantial positive correlation between the dose of neck RT and AS. Conclusions: Vascular changes in survivors of childhood Hodgkin lymphoma after neck RT seem to be long-term. Therefore, these patients may have an increased risk of stroke. We suggest refinement of international guidelines according to our results.
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Popit et al. (2023) conducted a case-control in Survivors of childhood Hodgkin lymphoma (n=136). Neck radiotherapy vs. Healthy controls was evaluated on Arterial stiffness (AS) of carotid arteries (B = 0.037, p=<0.05). Neck radiotherapy in childhood Hodgkin lymphoma survivors was associated with a significant long-term increase in carotid arterial stiffness compared to healthy controls (p < 0.05).
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