Martin Joseph D, Buckley Anne R, Graeb Doug, Walman Brenda, Salvian Anthony, Hay John H
Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
Int J Radiat Oncol Biol Phys. 2005 Nov 15;63(4):1197-205. doi: 10.1016/j.ijrobp.2005.04.017. Epub 2005 Jun 22.
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.
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.
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.
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.
确定接受同侧头颈部放疗且无脑血管疾病症状患者的颈动脉狭窄患病率。
40例患者接受了颈动脉超声和计算机断层血管造影检查。在配对分析中，将受照射侧的血管与未受照射侧的血管在任何狭窄情况、颈内动脉/颈动脉球部狭窄≥60%、内膜中层厚度（IMT）以及血管壁异常分级方面进行比较。记录病史、进行体格检查并检测空腹血水平，以发现颈动脉疾病的危险因素。
14例受照射的颈动脉出现一处或多处狭窄，而未受照射的颈动脉有5处出现狭窄（p = 0.03）。受照射的颈动脉中有6处球部/颈内动脉狭窄≥60%，未受照射的颈动脉中有1处（比值比6:1，p = 0.13）。受照射的颈动脉IMT和血管壁异常分级更高，但仅在剂量≥50 Gy时，且仅在位于放射野内的测量点处如此。
放疗似乎会导致颈动脉狭窄。颈动脉壁改变可能存在剂量阈值，这对多个肿瘤部位的放疗具有重要意义。
