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Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer()
OBJECTIVES: Presentation of radiation-induced lesions in carotid arteries of patients with head and neck squamous cell carcinoma (HNSCC) and the evaluation of the effectiveness of endovascular treatment of symptomatic stenoses. MATERIALS AND METHODS: We retrospectively analyzed 26 patients who under...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Neoplasia Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542749/ https://www.ncbi.nlm.nih.gov/pubmed/31146165 http://dx.doi.org/10.1016/j.tranon.2019.05.001 |
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author | Trojanowski, Piotr Sojka, Michał Trojanowska, Agnieszka Wolski, Andrzej Roman, Tomasz Jargiello, Tomasz |
author_facet | Trojanowski, Piotr Sojka, Michał Trojanowska, Agnieszka Wolski, Andrzej Roman, Tomasz Jargiello, Tomasz |
author_sort | Trojanowski, Piotr |
collection | PubMed |
description | OBJECTIVES: Presentation of radiation-induced lesions in carotid arteries of patients with head and neck squamous cell carcinoma (HNSCC) and the evaluation of the effectiveness of endovascular treatment of symptomatic stenoses. MATERIALS AND METHODS: We retrospectively analyzed 26 patients who underwent surgery and subsequently cervical radiotherapy (RT) for HNSCC, focusing on radiation-induced vascular disease in neck arteries—from the latency period to the occurrence of neurological events—and the endovascular treatment of the internal carotid artery (ICA) and/or of common carotid artery (CCA) stenoses. The vascular lesions were diagnosed with Doppler ultrasonography and selective digital angiography. Patients with >70% stenoses of ICA and/or CCA were scheduled for carotid artery stenting (CAS). They were followed-up with neurological examinations and Doppler ultrasonography at 6, 12, and 24 months after stenting. RESULTS: Radiation-induced vascular diseases occurred in the ICA in 22 patients (85%), CCA in 15 (58%), and in ECA in 15 (58%). The stents were implanted in 25 ICA and 17 CCA. Thirteen patients (50%) had one stent, eight (30%) had two stents, four (15%) had three stents, and one patient had five stents. Overall, 46 stents were implanted. Technical success was achieved in all patients. No cerebrovascular events occurred in the 24-months follow-up. CONCLUSION: RT in patients with HNSCC holds a significant risk factor of developing carotid artery stenosis and cerebrovascular events. Carotid stenting is preferable mode of treatment for radiation-induced stenosis. A screening program with doppler ultrasonography enables pre-stroke detection of carotid stenosis. |
format | Online Article Text |
id | pubmed-6542749 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Neoplasia Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-65427492019-06-03 Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() Trojanowski, Piotr Sojka, Michał Trojanowska, Agnieszka Wolski, Andrzej Roman, Tomasz Jargiello, Tomasz Transl Oncol Original article OBJECTIVES: Presentation of radiation-induced lesions in carotid arteries of patients with head and neck squamous cell carcinoma (HNSCC) and the evaluation of the effectiveness of endovascular treatment of symptomatic stenoses. MATERIALS AND METHODS: We retrospectively analyzed 26 patients who underwent surgery and subsequently cervical radiotherapy (RT) for HNSCC, focusing on radiation-induced vascular disease in neck arteries—from the latency period to the occurrence of neurological events—and the endovascular treatment of the internal carotid artery (ICA) and/or of common carotid artery (CCA) stenoses. The vascular lesions were diagnosed with Doppler ultrasonography and selective digital angiography. Patients with >70% stenoses of ICA and/or CCA were scheduled for carotid artery stenting (CAS). They were followed-up with neurological examinations and Doppler ultrasonography at 6, 12, and 24 months after stenting. RESULTS: Radiation-induced vascular diseases occurred in the ICA in 22 patients (85%), CCA in 15 (58%), and in ECA in 15 (58%). The stents were implanted in 25 ICA and 17 CCA. Thirteen patients (50%) had one stent, eight (30%) had two stents, four (15%) had three stents, and one patient had five stents. Overall, 46 stents were implanted. Technical success was achieved in all patients. No cerebrovascular events occurred in the 24-months follow-up. CONCLUSION: RT in patients with HNSCC holds a significant risk factor of developing carotid artery stenosis and cerebrovascular events. Carotid stenting is preferable mode of treatment for radiation-induced stenosis. A screening program with doppler ultrasonography enables pre-stroke detection of carotid stenosis. Neoplasia Press 2019-05-27 /pmc/articles/PMC6542749/ /pubmed/31146165 http://dx.doi.org/10.1016/j.tranon.2019.05.001 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original article Trojanowski, Piotr Sojka, Michał Trojanowska, Agnieszka Wolski, Andrzej Roman, Tomasz Jargiello, Tomasz Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() |
title | Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() |
title_full | Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() |
title_fullStr | Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() |
title_full_unstemmed | Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() |
title_short | Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer() |
title_sort | management of radiation induced carotid stenosis in head and neck cancer() |
topic | Original article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542749/ https://www.ncbi.nlm.nih.gov/pubmed/31146165 http://dx.doi.org/10.1016/j.tranon.2019.05.001 |
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