Pereira Eduardo B, Gemignani Tiago, Sposito Andrei C, Matos-Souza José R, Nadruz Wilson
Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Cidade Universitária "Zeferino Vaz", Campinas, SP 13081-970, Brasil.
Radiat Oncol. 2014 Jun 11;9:134. doi: 10.1186/1748-717X-9-134.
Radiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer. However, the risk factors of RT-induced carotid artery remodeling are not established. This study aimed to investigate the effects of RT on carotid and popliteal arteries in subjects with head and neck cancer and to evaluate the relationship between baseline clinical and laboratory features and the progression of RT-induced atherosclerosis.
Eleven men (age = 57.9 ± 6.2years) with head and neck cancer who underwent cervical bilateral irradiation were prospectively examined by clinical and laboratory analysis and by carotid and popliteal ultrasound before and after treatment (mean interval between the end of RT and the post-RT assessment = 181 ± 47 days). No studied subject used hypocholesterolemic medications. Significant increases in carotid intima-media thickness (IMT) (0.95 ± 0.08 vs. 0.87 ± 0.05 mm; p < 0.0001) and carotid IMT/diameter ratio (0.138 ± 0.013 vs. 0.129 ± 0.014; p = 0.001) were observed after RT, while no changes in popliteal structural features were detected. In addition, baseline low-density lipoprotein cholesterol levels showed a direct correlation with RT-induced carotid IMT change (r = 0.66; p = 0.027), while no other studied variable exhibited a significant relationship with carotid IMT change.
These results indicate that RT-induced atherosclerosis is limited to the irradiated area and also suggest that it may be predicted by low-density lipoprotein cholesterol levels in subjects with head and neck cancer.
放疗（RT）是头颈部癌患者颈动脉加速动脉粥样硬化疾病的危险因素。然而，放疗诱导颈动脉重塑的危险因素尚未明确。本研究旨在调查放疗对头颈部癌患者颈动脉和腘动脉的影响，并评估基线临床和实验室特征与放疗诱导的动脉粥样硬化进展之间的关系。
11名接受双侧颈部照射的头颈部癌男性患者（年龄=57.9±6.2岁），在治疗前后通过临床和实验室分析以及颈动脉和腘动脉超声进行前瞻性检查（放疗结束至放疗后评估的平均间隔时间=181±47天）。没有研究对象使用降胆固醇药物。放疗后观察到颈动脉内膜中层厚度（IMT）显著增加（0.95±0.08 vs. 0.87±0.05mm；p<0.0001）以及颈动脉IMT/直径比值增加（0.138±0.013 vs. 0.129±0.014；p=0.001），而腘动脉结构特征未检测到变化。此外，基线低密度脂蛋白胆固醇水平与放疗诱导的颈动脉IMT变化呈直接相关（r=0.66；p=0.027），而其他研究变量与颈动脉IMT变化均未表现出显著关系。
这些结果表明，放疗诱导的动脉粥样硬化仅限于照射区域，也提示头颈部癌患者的低密度脂蛋白胆固醇水平可能可预测该情况。
