Radiation-induced carotid artery atherosclerosis
Dorothy M Gujral1, Navtej Chahal2, Roxy Senior2
1Head and Neck Unit, Royal Marsden Hospital, London, United Kingdom.
Summary
Radiotherapy to the neck increases the risk of stroke and carotid artery stenosis (CAS). This review found significant increases in CAS and carotid intima-medial thickness (CIMT) following radiation therapy (RT).
Area of Science:
- Oncology
- Vascular Medicine
- Radiology
Background:
- Carotid arteries are frequently exposed to radiation during cancer treatment.
- Radiation exposure can lead to vascular injury, increasing the risk of carotid artery stenosis (CAS), stroke, and transient ischemic attack (TIA).
Purpose of the Study:
- To systematically review the effects of radiotherapy (RT) on carotid arteries.
- To examine stroke incidence in patients receiving neck RT.
- To assess surrogate endpoints like CAS and carotid intima-medial thickness (CIMT) for radiation-induced carotid atherosclerosis.
Main Methods:
- Systematic review of 34 articles from 853 references.
- Analysis of studies investigating stroke/TIA incidence (9 studies), CAS (11 studies), and CIMT (14 studies).
Main Results:
- Relative risk of stroke ranged from 1.12 (breast cancer) to 5.6 (head and neck cancer).
- Prevalence of CAS increased by 16-55%.
- Carotid intima-medial thickness (CIMT) increased by 18-40% in irradiated arteries, with significant increases noted in matched-control studies and early prospective data.
Conclusions:
- Neck radiotherapy significantly increases stroke incidence.
- Consistent differences in CAS and CIMT were observed between irradiated and unirradiated carotid arteries.
- Future research should utilize optimized control groups to better understand radiation effects.
Related Concept Videos
01:30Atherosclerosis I: Introduction
Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...