Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, 130021, China.
Department of Hematology and Medical Oncology, Moffitt Cancer Center, Tampa, FL, 33612, USA.
Biomed Pharmacother. 2020 Nov;131:110664. doi: 10.1016/j.biopha.2020.110664. Epub 2020 Aug 28.
Radiotherapy has significantly improved the survival of cancer patients but is also associated with several adversities, including radiation-induced carotid injury (RICI). The RICI mechanisms are complex, including vessel inflammatory injury, carotid atherosclerosis, intimal proliferation, media necrosis, and peri-adventitial fibrosis. The main manifestation and adverse consequence of RICI is carotid artery stenosis (CAS), which can lead to stroke and transient ischemic attack. Currently, carotid artery injury is primarily diagnosed via color-coded duplex sonography. Early detection of traumatic changes in the carotid artery depends on measurements of carotid intima-media thickness; serum biomarker testing also shows great potential. CAS is mainly treated with carotid endarterectomy or carotid angioplasty and stent implantation. Notably, bone marrow mesenchymal stem cells are advantageous in RICI treatment and reduce carotid inflammation, oxidative stress, and delaying atherosclerosis. This review summarizes the mechanisms, examination methods, and latest treatments for RICI to provide data for its clinical prevention and treatment.
放射治疗显著提高了癌症患者的生存率，但也与多种不良事件相关，包括放射性颈动脉损伤（RICI）。RICI 的机制复杂，包括血管炎症损伤、颈动脉粥样硬化、内膜增殖、中膜坏死和外膜纤维化。RICI 的主要表现和不良后果是颈动脉狭窄（CAS），可导致中风和短暂性脑缺血发作。目前，颈动脉损伤主要通过彩色双功能超声诊断。早期检测颈动脉创伤性改变依赖于颈动脉内膜-中层厚度的测量；血清生物标志物检测也显示出巨大的潜力。CAS 主要通过颈动脉内膜切除术或颈动脉血管成形术和支架植入术治疗。值得注意的是，骨髓间充质干细胞在 RICI 治疗中具有优势，可减轻颈动脉炎症、氧化应激和延缓动脉粥样硬化。本综述总结了 RICI 的机制、检查方法和最新治疗方法，为其临床防治提供了数据。
