头颈部癌放疗后颈动脉狭窄的患病率：一项系统评价和荟萃分析。
Prevalence of carotid stenosis following radiotherapy for head and neck cancer: A systematic review and meta-analysis.
作者信息
Texakalidis Pavlos, Giannopoulos Stefanos, Tsouknidas Ioannis, Song Shiyu, Rivet Dennis J, Reiter Evan R, Reavey-Cantwell John
机构信息
Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.
Department of Cardiology, University of Colorado, Denver, Colorado.
出版信息
Head Neck. 2020 May;42(5):1077-1088. doi: 10.1002/hed.26102. Epub 2020 Feb 12.
BACKGROUND
Radiation to the head and neck is a well-established risk factor for the development of carotid artery stenosis. Our objective was to identify the prevalence, incidence, and degree of carotid stenosis in patients with a history of head and neck irradiation.
METHODS
This study was performed according to the PRISMA guidelines. A random effects model meta-analysis was conducted.
RESULTS
Nineteen studies comprising 1479 patients were included. The prevalence of carotid stenosis >50%, >70%, and carotid occlusion was 25% (95% CI: 19%-32%), 12% (95% CI: 7%-17%), and 4% (95% CI: 2%-8%), respectively. The cumulative 12-month incidence of carotid stenosis >50% was 4% (95% CI: 2%-5%), the 24-month was 12% (95% CI: 9%-15%), and the 36-month was 21% (95% CI: 9%-36%).
CONCLUSIONS
The yearly incidence of carotid stenosis >50% increased every year during the first 3 years following radiotherapy. We propose routine yearly Doppler ultrasound screening beginning 1 year after head and neck radiotherapy.
背景
头颈部放疗是已明确的颈动脉狭窄发生的危险因素。我们的目的是确定有头颈部放疗史患者的颈动脉狭窄患病率、发病率及狭窄程度。
方法
本研究按照PRISMA指南进行。采用随机效应模型进行荟萃分析。
结果
纳入了19项研究，共1479例患者。颈动脉狭窄>50%、>70%及颈动脉闭塞的患病率分别为25%（95%CI：19%-32%）、12%（95%CI：7%-17%）和4%（95%CI：2%-8%）。颈动脉狭窄>50%的12个月累积发病率为4%（95%CI：2%-5%），24个月为12%（95%CI：9%-15%），36个月为21%（95%CI：9%-36%）。
结论
放疗后的前3年，颈动脉狭窄>50%的年发病率逐年增加。我们建议在头颈部放疗1年后开始每年进行常规多普勒超声筛查。
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