Popit Matjaž, Zaletel Marjan, Žvan Bojana, Zaletel Lorna Zadravec
General Hospital Murska Sobota, Ulica dr. Vrbnjaka 6, 9000 Murska Sobota, Slovenia.
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
Cancers (Basel). 2023 Aug 6;15(15):3992. doi: 10.3390/cancers15153992.
Survivors of Hodgkin lymphoma are recognized to have an increased risk of stroke and carotid artery disease owing to neck irradiation (RT). However, it remains unclear whether the vascular modifications induced by the treatment of Hodgkin lymphoma during childhood persist over the long term.
Our matched study involved 79 survivors of Hodgkin lymphoma in childhood who received neck RT and 57 healthy controls. Parameters of arterial stiffness (AS), intima-media thickness (IMT), and flow-mediated dilation (FMD) of carotid arteries were assessed using ultrasound.
Our patient cohort demonstrated a significant increase in AS compared to controls ( < 0.05), though no such disparity was observed for FMD ( = 0.111). Neck RT intensified AS (B = 0.037, = 0.000), while anthracyclines attenuated it (B = -0.803, = 0.000). Multivariate analysis revealed a positive correlation between neck RT ( < 0.001) and AS. However, we found no significant association between neck RT and FMD ( = 0.277). We identified a substantial positive correlation between the dose of neck RT and AS.
Vascular changes in survivors of childhood Hodgkin lymphoma after neck RT seem to be long-term. Therefore, these patients may have an increased risk of stroke. We suggest refinement of international guidelines according to our results.
霍奇金淋巴瘤幸存者因颈部放疗（RT）而被认为患中风和颈动脉疾病的风险增加。然而，儿童期霍奇金淋巴瘤治疗所引起的血管改变是否会长期持续尚不清楚。
我们的配对研究纳入了79名接受颈部放疗的儿童期霍奇金淋巴瘤幸存者和57名健康对照者。使用超声评估颈动脉的动脉僵硬度（AS）、内膜中层厚度（IMT）和血流介导的血管舒张（FMD）参数。
与对照组相比，我们的患者队列显示AS显著增加（<0.05），尽管FMD未观察到这种差异（=0.111）。颈部放疗加剧了AS（B=0.037，=0.000），而蒽环类药物则减轻了AS（B=-0.803，=0.000）。多变量分析显示颈部放疗（<0.001）与AS之间呈正相关。然而，我们发现颈部放疗与FMD之间无显著关联（=0.277）。我们确定颈部放疗剂量与AS之间存在显著正相关。
儿童期霍奇金淋巴瘤幸存者颈部放疗后的血管变化似乎是长期的。因此，这些患者中风风险可能增加。我们建议根据我们的结果完善国际指南。
