Vascular events from carotid artery atherosclerosis after radiation therapy for laryngeal and hypopharyngeal cancer: the incidence and risk factors.
Vascular events from carotid artery atherosclerosis after radiation therapy for laryngeal and hypopharyngeal cancer: the incidence and risk factors.
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DOI：
10.18999/nagjms.82.4.747
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发表时间：
2020-11
影响因子：
0.9
通讯作者：
Matsuo M
中科院分区：
文献类型：
--
作者：
Makita C;Okada S;Kajiura Y;Tanaka O;Asahi Y;Yamada N;Yanagida M;Kumagai M;Murase S;Ito M;Kumano T;Matsuo M
在这项回顾性队列研究中，我们评估了喉癌和下咽癌放疗后颈动脉粥样硬化血管事件的发生率。从2007年1月至2016年12月，我们研究了111例接受根治性放疗并随访≥1年（中位随访时间为60个月）的喉癌/下咽癌患者。我们评估了颈动脉粥样硬化（定义为短暂性脑缺血发作或动脉粥样硬化血栓性脑梗死）或接受颈动脉狭窄治疗（如颈动脉支架植入术）的血管事件发生率。中位放射剂量为66戈伊（范围，60-74）; 48例患者（43.2%）接受同期化疗。5年总生存率为86.2%。6名患者需要治疗颈动脉疾病。在3例颈动脉狭窄患者中进行了颈动脉支架植入术; 3例患者在放疗开始后发生了动脉粥样硬化性脑梗死并接受了药物治疗，中位时间为51.7个月（范围，0.3-78.3）。5年内血管事件发生率为5.4%，8年内为10.7%。在单变量分析中，血脂异常、糖尿病和颈动脉钙化是事件发生的重要因素。由于6例病例中有3例发生在照射野外，因此颈动脉或颈动脉球剂量测定参数均未显示出显著相关性。由于喉癌/下咽癌患者，特别是伴有血脂异常和糖尿病等并发症的患者，放疗后颈动脉狭窄的风险较高，因此有必要进行长期颈动脉评估。中风专家的早期干预可以降低致命性脑梗死的风险。
In this retrospective cohort study, we evaluated the incidence of vascular events from carotid artery atherosclerosis after radiotherapy indication for laryngeal and hypopharyngeal cancer. From January 2007 to December 2016, we investigated 111 laryngeal/hypopharyngeal cancer patients who underwent curative radiotherapy and were followed up for ≥1 year (median follow-up duration, 60 months). We evaluated the incidence of vascular events from carotid artery atherosclerosis, defined as a transient ischemic attack or an atherothrombotic cerebral infarction, or from undergoing treatment such as carotid artery stenting for carotid artery stenosis. The median radiation dose was 66 Gy (range, 60–74); 48 patients (43.2%) received concurrent chemotherapy. The 5-year overall survival was 86.2%. Six patients required treatment for carotid artery disease. Carotid stenting was performed in three patients with carotid artery stenosis; three patients developed atherosclerotic cerebral infarction and received medical treatment, with a median of 51.7 months (range, 0.3–78.3) after radiotherapy initiation. The vascular event occurrence rate was 5.4% within 5 years and 10.7% within 8 years. In the univariate analysis, dyslipidemia, diabetes mellitus, and carotid calcification were significant factors for event occurrence. Because three out of six cases occurred out of the irradiated field, no carotid artery or carotid bulb dosimetric parameters showed significant correlation. As laryngeal/hypopharyngeal cancer patients, particularly with complications including dyslipidemia and diabetes mellitus, are at a high risk of carotid artery stenosis after radiotherapy, long-term carotid artery evaluation is necessary. Early intervention by stroke specialists can reduce the risk of fatal cerebral infarction.
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影响因子：
45.3
作者：
Dorresteijn, LDA;Kappelle, AC;Bartelink, H
通讯作者：
Bartelink, H
DOI：
10.1016/j.jstrokecerebrovasdis.2003.11.025
发表时间：
2004-01-01
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
--
作者：
Kimura, Kazumi;Kazui, Seiji;Yamaguchi, Takenori
通讯作者：
Yamaguchi, Takenori
影响因子：
9.9
作者：
Marcel, M;Leys, D;Henon, H
通讯作者：
Henon, H
影响因子：
2.9
作者：
Lam, WWM;Liu, KH;Metreweli, C
通讯作者：
Metreweli, C
影响因子：
3.2
作者：
Haneda M;Noda M;Origasa H;Noto H;Yabe D;Fujita Y;Goto A;Kondo T;Araki E
通讯作者：
Araki E