Wang Liao1, Yuqiu Zheng2, Shangqing Bi3, Bei Zhang4, Ying Xiong5, Yi Li5, Wenli Fang5, Songhua Xiao5, Lianhong Yang5, Anderson Thea6, Jun Liu7. 1. Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, USA. 2. Department of Neurology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China. 3. Department of Geratology, Bao'an TCM Hospital Group, Shenzhen, China. 4. Department of Neurology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China. 5. Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. 6. Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, USA. 7. Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Laboratory of RNA and Major Diseases of Brain and Heart, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China. Electronic address: docliujun@hotmail.com.
Abstract
PURPOSE: Radiotherapy (RT) is the most effective treatment for nasopharyngeal carcinoma (NPC) but may cause stenosis of the carotid arteries. This meta-analysis evaluates the prevalence of carotid stenosis after radiation therapy. MATERIALS AND METHODS: Online search for studies reporting carotid stenosis in patients with NPC who received radiation therapy (RT) compared to NPC patients who did not receive RT and compared to healthy controls. RESULTS: Twelve studies were included for a total analysis of 1928 patients (837 received RT and 1091 were controls). RT patients showed a statistically significant higher incidence of overall stenosis (pooled risk ratio = 4.17 [2.44, 7.10], p < 0.00001) and an even greater incidence of significant stenosis (50% or more) (pooled risk ratio = 8.72 [3.53, 21.55], p < 0.00001). Analyzing by individual blood vessels showed that the RT patients had significantly higher incidence of stenosis in common carotid artery (CCA), external carotid artery (ECA), carotid bulb, CCA and internal carotid artery (ICA), and CCA/ICA/carotid bulb. CONCLUSIONS: NPC patients who receive RT have increased risk of developing carotid stenosis, and should be screened after treatment.
PURPOSE: Radiotherapy (RT) is the most effective treatment for nasopharyngeal carcinoma (NPC) but may cause stenosis of the carotid arteries. This meta-analysis evaluates the prevalence of carotid stenosis after radiation therapy. MATERIALS AND METHODS: Online search for studies reporting carotid stenosis in patients with NPC who received radiation therapy (RT) compared to NPCpatients who did not receive RT and compared to healthy controls. RESULTS: Twelve studies were included for a total analysis of 1928 patients (837 received RT and 1091 were controls). RT patients showed a statistically significant higher incidence of overall stenosis (pooled risk ratio = 4.17 [2.44, 7.10], p < 0.00001) and an even greater incidence of significant stenosis (50% or more) (pooled risk ratio = 8.72 [3.53, 21.55], p < 0.00001). Analyzing by individual blood vessels showed that the RT patients had significantly higher incidence of stenosis in common carotid artery (CCA), external carotid artery (ECA), carotid bulb, CCA and internal carotid artery (ICA), and CCA/ICA/carotid bulb. CONCLUSIONS:NPCpatients who receive RT have increased risk of developing carotid stenosis, and should be screened after treatment.