title: Clinical features of radiation-induced carotid atherosclerosis.
abstract: Carotid arteries frequently receive significant incidental doses of radiation during the treatment of malignant diseases, including head and neck cancer, breast cancer and lymphoma. Vascular injury after treatment may result in carotid artery stenosis and increased risk of neurological sequelae, such as stroke and transient ischaemic attack. The long latent interval from treatment to the development of clinical complications makes investigation of this process difficult, particularly in regard to the design of interventional clinical studies. Nevertheless, there is compelling clinical evidence that radiation contributes to carotid atherosclerosis. This overview examines the effect of radiotherapy on the carotid arteries, the underlying pathological processes and their clinical manifestations. The use of serum biomarkers in risk-prediction models and the potential value of new imaging techniques as tools for defining earlier surrogate end points will also be discussed.
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, London, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Gujral
authors.affiliation: Department of Echocardiography, Royal Brompton Hospital, London, UK.
authors.forename: B N
authors.initials: BN
authors.lastname: Shah
authors.affiliation: Department of Echocardiography, Royal Brompton Hospital, London, UK.
authors.forename: N S
authors.initials: NS
authors.lastname: Chahal
authors.affiliation: Department of Echocardiography, Royal Brompton Hospital, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Senior
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, London, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Harrington
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, London, UK. Electronic address: Chris.Nutting@rmh.nhs.uk.
authors.forename: C M
authors.initials: CM
authors.lastname: Nutting
mesh_terms: D002339:Carotid Arteries / Q000473:pathology / Q000528:radiation effects*; D002340:Carotid Artery Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors
keywords: Atherosclerosis; carotid artery; late effects; radiotherapy