背景:我们前瞻性评估了接受单侧颈部放疗(RT)治疗的头颈部癌患者颈动脉的形态和功能变化。
方法:在放疗后0、3、6、12、18个月和2、3、4和5年进行双侧颈动脉双工研究。内膜介质厚度(IMT);全球和区域圆周,以及径向应变,动脉弹性,刚度,并计算了扩张性。
结果:纳入38例患者。在18个月时检测到照射和未照射颈动脉的IMT与基线的显着差异(中位数,0.073mm对-0.003mm;P=0.014),在3年和4年增加(0.128毫米对0.013毫米,P=0.016,0.177mm对0.023mm,分别为P=0.0002)。在6个月时,受辐照和未辐照的动脉之间的整体圆周应变出现了显着的瞬时变化(中位数差异,-0.89,P=0.023),没有坚持。在其他弹性测量中没有检测到显著差异,刚度,和扩张性。
结论:颈动脉超声检测颈动脉的功能和形态改变,如6个月时的全球周向应变变化和18个月时的颈动脉IMT变化,可能有助于早期发现辐射引起的颈动脉损伤,可以指导未来旨在缓解颈动脉狭窄的研究,并应考虑作为头颈部RT后临床监测生存建议。
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.
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.
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.
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.