Key result
Head and neck cancer radiotherapy linked to ~12% greater carotid IMT versus surgery alone.
Why the study?
The critical irradiation dose and the onset of intima-media thickness increase as a marker for post-irradiation vasculopathy in head and neck cancer patients remain unclear.
Does radiotherapy increase carotid artery intima-media thickness in head and neck cancer patients?
Cross-Sectional (n=137)
No
Does radiotherapy increase carotid artery intima-media thickness in head and neck cancer patients?
Radiotherapy for head and neck cancer causes a dose-dependent increase in carotid IMT, suggesting IMT sonography is a useful screening tool for early detection of post-irradiation vasculopathy.
Answers are grounded in this paper and cite their sources.
IMT may flag early RT-induced carotid damage in head and neck survivors; leaves open whether screening improves cerebrovascular outcomes.
PURPOSE: Post-irradiation vasculopathy is a severe form of atherosclerosis and affects the prognosis of head and neck cancer survivors. Sonographic intima-media thickness (IMT) precedes stenosis, plaque formation, and cerebrovascular events. Therefore, IMT may be a valuable screening marker for post-irradiation toxicity. However, the critical irradiation dose and the onset of IMT increase remain unclear. METHODS: The cross-sectional study analysed the carotid artery IMT in 96 irradiated patients and 41 controls regarding irradiation dose, post-irradiation-interval, and cardiovascular risk factors. Distinct irradiation doses to the tumour side and the contralateral hemineck enabled detection of dose depended effects within one patient and control of risk factors. RESULTS: Radiotherapy caused a dose-dependent increase in IMT. The toxicity did not have saturation effects for > 60 Gy. The IMT increase occurred in short-term following radiotherapy and the risk for a pathological value (> 0.9 mm) rose significantly. The correlation between IMT and radiotherapy was comparable to established cardiovascular risk factors. CONCLUSION: Radiotherapists should consider the additional toxicity of high doses for non-metastatic head and neck cancer. If neck metastases require radiotherapy with boost, IMT measurement is suitable for early detection of carotid artery damage.
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Strüder et al. (2020) conducted a cross-sectional in Head and neck squamous cell cancer (n=137). Radiotherapy vs. Surgery only or healthy controls was evaluated on Mean carotid artery intima-media thickness (IMT) (p=<0.05).
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