Joyce Wilbers1, Lucille D Dorresteijn2, Roy Haast3, Frank J Hoebers4, Johannes H Kaanders5, Willem Boogerd6, Erik D van Werkhoven7, Marlies E Nowee8, Hendrik H G Hansen9, Chris L de Korte10, Arnoud C Kappelle11, Ewoud J van Dijk12. 1. Department of Neurology, Radboud University Nijmegen Medical Center, The Netherlands. Electronic address: Joyce.Wilbers@radboudumc.nl. 2. Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands. Electronic address: L.Dorresteijn@mst.nl. 3. Department of Neurology, Radboud University Nijmegen Medical Center, The Netherlands. Electronic address: roy.haast@maastrichtuniversity.nl. 4. Maastricht University Medical Center, Department of Radiation Oncology (MAASTRO clinic), The Netherlands. Electronic address: frank.hoebers@maastro.nl. 5. Department of Radiation Oncology, University Nijmegen Medical Center, The Netherlands. Electronic address: j.kaanders@radboudumc.nl. 6. Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: w.boogerd@nki.nl. 7. Department of Biometrics, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: e.v.werkhoven@nki.nl. 8. Department of Radiotherapy, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: m.nowee@nki.nl. 9. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Rik.Hansen@radboudumc.nl. 10. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Chris.deKorte@radboudumc.nl. 11. Department of Neurology, Radboud University Nijmegen Medical Center, The Netherlands. Electronic address: Arnoud.Kappelle@radboudumc.nl. 12. Department of Neurology, Radboud University Nijmegen Medical Center, The Netherlands. Electronic address: Ewoud.vanDijk@radboudumc.nl.
Abstract
BACKGROUND AND PURPOSE: Carotid artery vasculopathy is a long-term complication of radiotherapy (RT) of the neck. We investigated the change in carotid intima media thickness (IMT) and the incidence of ischemic stroke in the first 7 years after radiotherapy (RT) of the neck. MATERIALS AND METHODS: A multicentre prospective cohort study among patients treated for Head and Neck Cancer (HNC) assessed carotid IMT at baseline (before RT) and after a median of 7 years follow-up. We also screened for cerebrovascular risk factors and events. RESULTS: 48 patients underwent IMT measurement at baseline and follow-up (median age 61 years, range 29-87). Mean IMT of the irradiated common carotid arteries was 0.64mm at baseline and 0.74mm at follow-up (p=0.002). Mean delta IMT in the irradiated and non-irradiated common carotid arteries were 0.11 and 0.02mm (p=0.03). Incidence rate of stroke in our cohort, compared to the Dutch population was 8.9 versus 1.5 per 1.000 person years. CONCLUSIONS: IMT in irradiated carotid arteries was significantly increased in the first 7years after RT. The incidence rate of stroke was six fold increased. Patients treated with RT for HNC have sustained risk for developing atherosclerosis of the carotid arteries and future stroke.
BACKGROUND AND PURPOSE: Carotid artery vasculopathy is a long-term complication of radiotherapy (RT) of the neck. We investigated the change in carotid intima media thickness (IMT) and the incidence of ischemic stroke in the first 7 years after radiotherapy (RT) of the neck. MATERIALS AND METHODS: A multicentre prospective cohort study among patients treated for Head and Neck Cancer (HNC) assessed carotid IMT at baseline (before RT) and after a median of 7 years follow-up. We also screened for cerebrovascular risk factors and events. RESULTS: 48 patients underwent IMT measurement at baseline and follow-up (median age 61 years, range 29-87). Mean IMT of the irradiated common carotid arteries was 0.64mm at baseline and 0.74mm at follow-up (p=0.002). Mean delta IMT in the irradiated and non-irradiated common carotid arteries were 0.11 and 0.02mm (p=0.03). Incidence rate of stroke in our cohort, compared to the Dutch population was 8.9 versus 1.5 per 1.000 person years. CONCLUSIONS: IMT in irradiated carotid arteries was significantly increased in the first 7years after RT. The incidence rate of stroke was six fold increased. Patients treated with RT for HNC have sustained risk for developing atherosclerosis of the carotid arteries and future stroke.
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Authors: Floris C J Reinders; Tristan C F van Heijst; Joel Mases; Chris H J Terhaard; Patricia A H Doornaert; Marielle E P Philippens; Cornelis P J Raaijmakers Journal: Phys Imaging Radiat Oncol Date: 2021-11-10
Authors: Joyce Wilbers; Arnoud C Kappelle; Laura Versteeg; Anil M Tuladhar; Stefan C A Steens; Frederick J A Meijer; Willem Boogerd; Lucille D Dorresteijn; Johannes H Kaanders; Roy P C Kessels; Ewoud J van Dijk Journal: Neurooncol Pract Date: 2015-05-07
Authors: D Strüder; S Hellwig; H Rennau; S van Bonn; S P Schraven; R Mlynski; G Hildebrandt; T Schuldt Journal: Eur Arch Otorhinolaryngol Date: 2020-09-01 Impact factor: 2.503