Carotid and vertebral artery stenosis evaluated by contrast-enhanced MR angiography in nasopharyngeal carcinoma patients after radiotherapy: a prospective cohort study

Zhou, Lijuan; Xing, Pengfei; Y, Chen; Xu, Xiaogang; Shen, Jian; Lu, Xiaohuan

doi:10.1259/bjr.20150175

Cited by 32 publications

(27 citation statements)

References 31 publications

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“…One study evaluated carotid stenosis of NPC patients by using contrast-enhanced MR angiography scanning. They found a rate of 37.5%, which is higher than our finding 19 . The difference may be attributed to different measurement methods as was discussed by the authors.…”

Section: Discussioncontrasting

confidence: 86%

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Comparison of Significant Carotid Stenosis for Nasopharyngeal Carcinoma between Intensity-Modulated Radiotherapy and Conventional Two-Dimensional Radiotherapy

Zhou

Fan

Zheng

et al. 2018

Sci Rep

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Radiotherapy (RT) serves as the most efficient treatment for nasopharyngeal carcinoma (NPC) and can cause carotid stenosis. This work compared the incidence of significant carotid stenosis between intensity-modulated radiotherapy (IMRT) and two-dimensional conventional radiotherapy (2D-RT) for NPC and explored the risk factors. We retrospectively reviewed 233 cases with NPC who underwent carotid ultrasound post IMRT or 2D-RT from 2006 to 2015. The incidence of significant stenosis after RT was 19.3%. Significant stenosis was identified in 20 (14.6%) of 137 patients treated with IMRT and 25 (26.0%) of 96 patients with 2D-RT, respectively (p = 0.035). Multivariate logistic analysis indicated age (odds ratio = 1.054, 95% CI = 1.011–1.099, p = 0.014), radiation technique (IMRT) (odds ratio = 0.471, 95%CI = 0.241–0.919, p = 0.027) and time interval (odds ratio = 1.068, 95%CI = 1.033–1.105, p = 0.001) as independent predictors for significant carotid stenosis. Our study suggests that IMRT was associated with decreased incidence of significant carotid stenosis versus 2D-RT for NPC. Prevention and carotid ultrasound should be considered for older NPC survivors with longer interval from RT, especially those treated with 2D-RT.

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Section: Discussioncontrasting

confidence: 86%

“…The present study illuminated that an older age might relate to a higher incidence of stenosis (≥50%) in NPC patients after RT treatment, consistent with the results of Zhou et al . 19 . They also found that the risk rose with time after RT.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Significant Carotid Stenosis for Nasopharyngeal Carcinoma between Intensity-Modulated Radiotherapy and Conventional Two-Dimensional Radiotherapy

Zhou

Fan

Zheng

et al. 2018

Sci Rep

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“…Imaging modality used for the detection of carotid stenosis was Doppler Ultrasound (DUS) in all studies except that by Dupin et al and Zhou et al, which used magnetic resonance imaging. 27,39…”

Section: Characteristics Of the Included Studies And Patientsmentioning

confidence: 99%

Prevalence of carotid stenosis following radiotherapy for head and neck cancer: A systematic review and meta‐analysis

et al. 2020

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Background: Radiation to the head and neck is a well-established risk factor for the development of carotid artery stenosis. Our objective was to identify the prevalence, incidence, and degree of carotid stenosis in patients with a history of head and neck irradiation. Methods: This study was performed according to the PRISMA guidelines. A random effects model meta-analysis was conducted. Results: Nineteen studies comprising 1479 patients were included. The prevalence of carotid stenosis >50%, >70%, and carotid occlusion was 25% (95% CI: 19%-32%), 12% (95% CI: 7%-17%), and 4% (95% CI: 2%-8%), respectively. The cumulative 12-month incidence of carotid stenosis >50% was 4% (95% CI: 2%-5%), the 24-month was 12% (95% CI: 9%-15%), and the 36-month was 21% (95% CI: 9%-36%). Conclusions:The yearly incidence of carotid stenosis >50% increased every year during the first 3 years following radiotherapy. We propose routine yearly Doppler ultrasound screening beginning 1 year after head and neck radiotherapy. K E Y W O R D S carotid stenosis, head and neck cancer, ionizing radiation, radiotherapy, screening

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“…9) Lam et al 14) evaluated vascular stenosis using ultrasonography after radiotherapy for head and neck tumors and reported that 50% or severer carotid artery stenosis was observed in 29.6% of the patients but that vertebral artery stenosis was rare, being noted in only 5.6%. On the other hand, Zhou et al 15) evaluated the presence or absence of vascular stenosis using contrast-enhanced MRA in 72 patients 3 years or longer after radiotherapy for nasopharyngeal cancer and reported that 50% or severer carotid artery stenosis was noted in 37.5% and that vertebral artery stenosis was noted in 34.7%, suggesting that the latter is not a rare condition. While the common carotid artery stenosis is a frequent inserting three Hydrosoft 4 mm × 10 cm (Terumo Corporation, Tokyo, Japan), three Hydrosoft 3 mm × 10 cm, and one 2.5 mm × 6 cm coils (Fig.…”

Section: Case Presentationmentioning

confidence: 99%

Endovascular Treatment for Basilar Artery Occlusion Caused by Radiation-induced Vertebral Artery Stenosis: Case Report

Tokumura

Ito

Terakado

et al. 2018

JNET

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Objective:We report endovascular treatment of a patient with acute basilar artery occlusion considered to be due to an embolus from radiation-induced vertebral artery stenosis.Case Presentation: The patient was a 46-year-old male with a history of neck irradiation. He developed basilar artery occlusion. Temporary recanalization achieved by intravenous alteplase therapy and revascularization was followed by relapse. The origin of the vertebral artery was stenosed, and basilar artery was considered to have been embolized by a thrombus formed on the proximal side of the vertebral artery, where blood flow was stagnated due to reduced antegrade flow from the distal side of the stenotic vertebral artery and the increased collateral flow from the deep cervical artery.Recurrence of cerebellar infarction could be prevented by revascularization and occlusion of the parent artery. Conclusion:Acute basilar artery occlusion considered to be due to an embolus from radiation-induced vertebral artery stenosis is a rare condition, but it must be recognized as a possible cause of posterior circulation infarction.

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Carotid and vertebral artery stenosis evaluated by contrast-enhanced MR angiography in nasopharyngeal carcinoma patients after radiotherapy: a prospective cohort study

Abstract: Radiation-induced CA and VA stenosis exists widely in patients with NPC after radiotherapy, and its prevalence is more common in patients with older age and longer interval from radiotherapy.

Cited by 32 publications

References 31 publications

Comparison of Significant Carotid Stenosis for Nasopharyngeal Carcinoma between Intensity-Modulated Radiotherapy and Conventional Two-Dimensional Radiotherapy

Comparison of Significant Carotid Stenosis for Nasopharyngeal Carcinoma between Intensity-Modulated Radiotherapy and Conventional Two-Dimensional Radiotherapy

Prevalence of carotid stenosis following radiotherapy for head and neck cancer: A systematic review and meta‐analysis

Endovascular Treatment for Basilar Artery Occlusion Caused by Radiation-induced Vertebral Artery Stenosis: Case Report

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