Abstract：
Our review aims to clarify the incidence of carotid artery stenosis, risks of development, screening, management, and primary prevention strategies documented in the literature after radiation therapy for head and neck cancers. The high prevalence of carotid stenosis after radiation therapy for head and neck cancers has made surveillance and risk stratification critical. In addition to general cardiovascular risk factors such as smoking, diabetes, and dyslipidemia, risk factors for carotid artery stenosis after head and neck radiation included total plaque score, radiotherapy use and dosage, length of time after radiotherapy, and age greater than 50. Cancer subtype, namely nasopharyngeal cancer, may be correlated with increased risk as well, though contrasting results have been found. Interestingly, however, no significant relationship has been found between radiotherapy dose and stroke risk. Surgical management of post-radiation carotid stenosis is similar to that of stenosis unrelated to radiation, with carotid endarterectomy considered to be the gold standard treatment and carotid artery stenting being an acceptable, less-invasive alternative. Medical management of these patients has not been well-studied, but antiplatelet therapy, statins, and blood pressure control may be beneficial. The mainstay of screening for radiation-induced stenosis has been Doppler ultrasound, with measurement of changes in the intima-media thickness being a primary marker of disease development. A literature review was carried out using the MeSH terms \"Carotid Artery Stenosis,\" \"Head and Neck Neoplasms,\" and \"Radiotherapy.\"
摘要：
我们的综述旨在阐明颈动脉狭窄的发生率，发展的风险,筛选,管理,和文献中记录的头颈癌放射治疗后的一级预防策略。头颈癌放射治疗后颈动脉狭窄的高患病率使监测和风险分层变得至关重要。除了一般的心血管危险因素，如吸烟，糖尿病,和血脂异常，头颈部放疗后颈动脉狭窄的危险因素包括总斑块评分,放射治疗的用途和剂量，放疗后的时间长度，年龄大于50。癌症亚型,即鼻咽癌，也可能与风险增加有关，尽管已经发现了相反的结果。有趣的是,然而,放疗剂量与卒中风险之间没有显著关系.放疗后颈动脉狭窄的手术治疗与放疗无关的狭窄相似，颈动脉内膜切除术被认为是金标准治疗，颈动脉支架置入术是可以接受的，侵入性较小的替代品。这些病人的医疗管理还没有得到很好的研究，但是抗血小板治疗,他汀类药物，和血压控制可能是有益的。筛查辐射引起的狭窄的主要方法是多普勒超声，测量内膜-中膜厚度的变化是疾病发展的主要标志。使用MeSH术语“颈动脉狭窄，头颈部肿瘤,“和”放射治疗。\"
