Risk of ischaemic cerebrovascular events in head and neck cancer patients is associated with carotid artery radiation dose.

Autor: van Aken ESM; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., van der Laan HP; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands. Electronic address: h.p.van.der.laan@umcg.nl., Bijl HP; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Van den Bosch L; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., van den Hoek JGM; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Dieters M; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Steenbakkers RJHM; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Langendijk JA; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2021 Apr; Vol. 157, pp. 182-187. Date of Electronic Publication: 2021 Feb 03.
DOI: 10.1016/j.radonc.2021.01.026
Abstrakt: Background and Purpose: Radiotherapy in the head and neck area may cause vascular damage to the carotid arteries, increasing the risk of anterior circulation ischaemic cerebrovascular events (ICVEs). However, limited data exists on the relationship between radiation dose to the carotid arteries and risk of ICVE. The purpose of this study was therefore to determine the relationship between radiation dose to the carotid arteries and anterior circulation ICVE risk.
Materials and Methods: A retrospective analysis of a prospective study cohort of 750 head and neck cancer patients treated with definitive (chemo)radiotherapy was performed. Carotid arteries were delineated, and dose-volume parameters of the treatment plans were calculated. ICVEs were scored prospectively and checked retrospectively by analysing all patient records. Cox proportional hazards analysis was performed to analyse the dose-effect relationships.
Results: The median follow-up period was 3.4 years, 27 patients experienced an ICVE and the 5-year cumulative risk was 4.6%. ICVE risk was significantly associated with dose to the carotid arteries. Multivariable analysis showed that the absolute volume (cm 3 ) of the carotid arteries that received at least a radiation dose of 10 Gy was the most important prognostic factor for ICVE (HR = 1.11, AUC = 0.68, p < 0.001).
Conclusion: This is the first large prospective cohort study that demonstrates an independent dose-effect relationship between radiation dose to the carotid arteries and the risk of ICVE. These findings may be used to identify patients at risk for ICVE after radiotherapy who may benefit from primary or secondary preventive measures.
(Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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