Screening for irradiation vasculopathy by intima-media thickness sonography in head and neck cancer patients

D. Strüder, S. Hellwig, H. Rennau, S. van Bonn, S. P. Schraven, R. Mlynski, G. Hildebrandt, T. Schuldt
2020 European Archives of Oto-Rhino-Laryngology  
Post-irradiation vasculopathy is a severe form of atherosclerosis and affects the prognosis of head and neck cancer survivors. Sonographic intima-media thickness (IMT) precedes stenosis, plaque formation, and cerebrovascular events. Therefore, IMT may be a valuable screening marker for post-irradiation toxicity. However, the critical irradiation dose and the onset of IMT increase remain unclear. The cross-sectional study analysed the carotid artery IMT in 96 irradiated patients and 41 controls
more » ... ts and 41 controls regarding irradiation dose, post-irradiation-interval, and cardiovascular risk factors. Distinct irradiation doses to the tumour side and the contralateral hemineck enabled detection of dose depended effects within one patient and control of risk factors. Radiotherapy caused a dose-dependent increase in IMT. The toxicity did not have saturation effects for > 60 Gy. The IMT increase occurred in short-term following radiotherapy and the risk for a pathological value (> 0.9 mm) rose significantly. The correlation between IMT and radiotherapy was comparable to established cardiovascular risk factors. Radiotherapists should consider the additional toxicity of high doses for non-metastatic head and neck cancer. If neck metastases require radiotherapy with boost, IMT measurement is suitable for early detection of carotid artery damage.
doi:10.1007/s00405-020-06301-3 pmid:32870365 fatcat:d7yyewyrwvcyxewj7gkyzvthye