The role of radiotherapy in the carotid stenosis

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COD: 04_932_2102 Categorie: ,

Giovanni Simonetti, Enrico Pampana, Isabel Di Poce, Augusto Orsini, Federico Pugliese, Sara Izzo, Luigi Basso, Virgilio Nicolanti, Monir Al Mansour, Pierfrancesco Di Cello, Luciano Izzo

Ann. Ital. Chir., 2014 85: 533-536

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OBJECTIVE: Cervical radiation for head and neck cancer has been associated with an increased incidence of carotid arterial stenosis. Modern radiation therapy delivers higher doses with increasing long-term survival. In our study 50 patients with head and neck malignancies treated with radiotherapy are analized with colour Doppler ultrasonographic scanning of the carotid arteries. These patients were compared with a population of asymptomatic historical controls (40) These findings suggest that radiation has an adverse effect on large vessels. Colour Doppler follow-up may be indicated for patients receiving head and neck radiation therapy.
METHODS: 50-70 Gy is the local dose that all patients received. during a period of about 8 weeks. The ecodoppler scan
of carotid arteries was performed in all patients with estimation of Common and internal carotid artery’s intimal medial
thickness (IMT). Stenosis grade were divided into low (0-30%), moderate (31-49 %) and severe (= >50%). In add
we considered ematochimics and flogosys parameters. Patients recruited from a hospital Radiation-oncology-surgery department from April 2007 to September 2011, 90 consecutive head and neck cancer patients were enrolled in this study.
50 of these patients had previously undergone RT (RT group) and 40 had no RT (control group). All patients were screened with bilateral carotid arterial duplex ultrasonography. We defined disease as “normal or mild” if the carotid
stenosis was <50%, and “significant” if >50%. The relationship between standard demographic risk factors and screening
outcomes was then analyzed.
RESULTS: We found that severe carotid stenosis (= >50% ) was higher (41%) in patients who underwent to radiotherapy
than in control group. The Eco Doppler examination demonstrated that the most affected site was Internal Carotid
Arthery ‘s fork . There were no differences in age or gender between the two groups. The RT group had a significantly
higher plaque score than the non-irradiated group. Bilateral plaque score was significantly correlated with age, hyperlipidemia, and RT. This analysis showed that in RT patients > 50 years old, age was inversely correlated with plaque
score; however, in RT patients

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