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Irradiation-induced atherosclerosis: a factor in therapeutic planning
W F McGuirt1, R S Feehs, G Bond
1Department of Otolaryngology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157.
The Annals of Otology, Rhinology, and Laryngology
|March 1, 1992
Summary
Neck irradiation may accelerate carotid atherosclerosis in head and neck cancer patients. This finding impacts treatment choices and long-term patient follow-up strategies.
Area of Science:
- Oncology
- Vascular Medicine
- Radiotherapy
Background:
- Debate exists regarding optimal treatment for early-stage head and neck cancers (Stages I-II) and occult metastatic neck disease, with surgery and irradiation as primary options.
- A critical, under-explored factor in this decision is the potential for radiotherapy to induce or accelerate carotid atherosclerosis.
Observation:
- Clinical case reports (n=9) and a retrospective study (n=57) investigated carotid atherosclerosis in irradiated head and neck cancer patients.
- A comparative study analyzed atherosclerosis extent and distribution in irradiated (n=29) versus non-irradiated (n=29) patients, controlling for age, blood pressure, and tobacco use.
Findings:
- Irradiated patients exhibited carotid atherosclerosis in a wider anatomical distribution and to a greater extent compared to non-irradiated controls.
- Neck irradiation was identified as a factor that induces and/or accelerates the development of carotid atherosclerosis.
Implications:
- Findings suggest carotid atherosclerosis is a significant complication of neck irradiation, influencing treatment selection for head and neck cancers.
- Pre-treatment evaluation and long-term follow-up protocols for irradiated patients should consider the accelerated progression of carotid atherosclerosis.