Longitudinal Changes in the Carotid Arteries of Head and Neck Cancer Patients Following Radiation Therapy: Results From a Prospective Serial Imaging Biomarker Characterization Study

Authors

Efstratios Koutroumpakis
Abdallah Sherif Radwan Mohamed
Peter Chaftari
David I Rosenthal
Dorothy Gujral
Christopher Nutting
Serageldin Kamel
Mohamed A Naser
Peter Kim
Roland Bassett
Clifton D Fuller
Elie Mouhayar
MD Anderson Head Neck Radiation Oncology Cardiovascular Working Group

Publication Date

6-1-2024

Journal

Radiotherapy & Oncology

Abstract

INTRODUCTION: We prospectively evaluated morphologic and functional changes in the carotid arteries of patients treated with unilateral neck radiation therapy (RT) for head and neck cancer.

METHODS: Bilateral carotid artery duplex studies were performed at 0, 3, 6, 12, 18 months and 2, 3, 4, and 5 years following RT. Intima media thickness (IMT); global and regional circumferential, as well as radial strain, arterial elasticity, stiffness, and distensibility were calculated.

RESULTS: Thirty-eight patients were included. A significant difference in the IMT from baseline between irradiated and unirradiated carotid arteries was detected at 18 months (median, 0.073 mm vs -0.003 mm; P = 0.014), which increased at 3 and 4 years (0.128 mm vs 0.013 mm, P = 0.016, and 0.177 mm vs 0.023 mm, P = 0.0002, respectively). A significant transient change was noted in global circumferential strain between the irradiated and unirradiated arteries at 6 months (median difference, -0.89, P = 0.023), which did not persist. No significant differences were detected in the other measures of elasticity, stiffness, and distensibility.

CONCLUSIONS: Functional and morphologic changes of the carotid arteries detected by carotid ultrasound, such as changes in global circumferential strain at 6 months and carotid IMT at 18 months, may be useful for the early detection of radiation-induced carotid artery injury, can guide future research aiming to mitigate carotid artery stenosis, and should be considered for clinical surveillance survivorship recommendations after head and neck RT.

Keywords

Humans, Head and Neck Neoplasms, Male, Female, Prospective Studies, Middle Aged, Carotid Arteries, Aged, Carotid Intima-Media Thickness, Adult, Longitudinal Studies

Comments

Supplementary Materials

PMID: 38467343