A historical prospective cohort study of carotid artery stenosis after radiotherapy for head and neck malignancies.
OBJECTIVE
To determine carotid artery stenosis incidence after radiotherapy for head-and-neck neoplasms.


METHODS
This historical prospective cohort study comprised 44 head-and-neck cancer survivors who received unilateral neck radiotherapy between 1974 and 1999. They underwent bilateral carotid duplex ultrasonography to detect carotid artery stenosis.


RESULTS
The incidence of significant carotid stenosis (8 of 44 [18%]) in the irradiated neck was higher than that in the contralateral unirradiated neck (3 of 44 [7%]), although this difference was not statistically significant (p = 0.13). The rate of significant carotid stenosis events increased as the time after radiotherapy increased. The risk of ipsilateral carotid artery stenosis was higher in patients who had undergone a neck dissection vs. those who had not. Patients with significant ipsilateral stenosis also tended to be older than those without significant stenosis. No other patient or treatment variables correlated with risk of carotid artery stenosis.


CONCLUSIONS
For long-term survivors after neck dissection and irradiation, especially those who are symptomatic, ultrasonographic carotid artery screening should be considered.
Brown
Paul D
PD
Division of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA.
Foote
Robert L
RL
McLaughlin
Mark P
MP
Halyard
Michele Y
MY
Ballman
Karla V
KV
Collie
A Craig
AC
Miller
Robert C
RC
Flemming
Kelly D
KD
Hallett
John W
JW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002343:Carotid Artery, Internal / Q000528:radiation effects*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018616:Ultrasonography, Doppler, Duplex