Author/Editor		Fernández-Alvarez, Verónica; López, Fernando; Suárez, Carlos; Strojan, Primož; Eisbruch, Avraham; Silver, Carl E.; Mendenhall, William M.; Langendijk, Johannes A.; Rinaldo, Alessandra; Lee, Anne W. M.
Title		Radiation-induced carotid artery lesions
Type		članek
Vol. and No.		Letnik 194, št. 8
Publication year		2018
Volume		str. 699-710
ISSN		0179-7158 - Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
Language		eng
Abstract		To review the current aspects of knowledge related to the risk of cerebrovascular events in patients receiving head and neck radiotherapy. METHODS: A literature search was performed in PubMed. Papers meeting selection criteria were reviewed. RESULTS: We provide an update on the problem by identifying key studies that have contributed to our current understanding of the epidemiology, radiologic features, pathogenesis, and treatment of the disease. The incidence of carotid artery stenosis ranged from 18 to 38% in patients who underwent radiotherapy for head and neck cancer versus from 0 to 9.2% among the nonirradiated patients. Neck irradiation increases the intima-media thickness of the carotid artery wall. These changes are the earliest visible alteration in the carotid wall and are also detected with color Doppler ultrasonography. Endovascular treatment with a carotid angioplasty and stenting is the first-line treatment for most symptomatic patients. CONCLUSIONS: Radiation-induced atherosclerosis is a different and accelerated form of atherosclerosis, which implies a more aggressive disease with a different biologic behavior. The disease is characterized by a high rate of carotid artery stenosis compared to those observed in nonirradiated control group patients. To prevent the risk of stroke, surveillance and imaging with ultrasonography should enable detection of severe stenosis. Endovascular treatment with a carotid angioplasty and stenting has been proposed as an attractive and minimally invasive alternative for some radiation-induced stenoses.
Keywords		radioterapija obsevanje arterijske lezije glava in vrat radiotherapy artery lesions head and neck