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Int J Radiat Oncol Biol Phys. 2005 Nov 15;63(4):1197-205. Epub 2005 Jun 22.

Carotid artery stenosis in asymptomatic patients who have received unilateral head-and-neck irradiation.

Author information

1
Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada. docjdmire@yahoo.com

Abstract

PURPOSE:

To determine the prevalence of carotid artery stenosis in patients who have received ipsilateral head-and-neck radiotherapy and have no symptoms of cerebrovascular disease.

METHODS AND MATERIALS:

Forty patients underwent ultrasound and computed tomography angiography of their carotid arteries. The vessels on the irradiated side were compared with those on the unirradiated side in a matched-pair analysis with regard to any stenosis, stenosis > or =60% in the internal carotid artery/carotid bulb, intima medial thickness (IMT), and grade of wall abnormalities. History, physical, and fasting blood levels were taken to detect risk factors for carotid disease.

RESULTS:

Fourteen irradiated carotid trees bore one or more stenosis vs. five in the unirradiated ones (p = 0.03). There were six bulb/internal carotid artery stenoses > or =60% in the irradiated carotids vs. one in the unirradiated (OR 6:1, p = 0.13). IMT and grade of vessel wall abnormality were higher in the irradiated carotids, but only at doses > or =50 Gy, and only at measurement points that lay within the radiation portals.

CONCLUSION:

Radiation appears to cause carotid artery stenosis. There may be a dose threshold for carotid wall changes, which has relevance for radiotherapy in several tumor sites.

PMID:
15978738
DOI:
10.1016/j.ijrobp.2005.04.017
[Indexed for MEDLINE]

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