The Clinical Retrospective Study Of Carotid Stenosis After Radiotherapy In Nasopharyngeal Carcinoma

BACKGROUND:Radiotherapy is main method to manage head and neck tumors.About half of patients with malignant tumor in head and neck could obtain long term survival through radiotherapy or combined therapy within radiotherapy.However,it is necessary to Clinical detected for whether carotid stenosis is a major sequela of head and neck irradiation,especially to long term survivors such as patients of.Nasopharyngeal Carcinoma,we should not only approach this injury and the degree of carotid stenosis but also the coherent factors to provide information to deduce and delay the incidence of this injury.This study retrospective analyses the condition of carotid artery between the research group of thirty Nasopharyngeal Carcinoma patients whom received radiotherapy in cancer hospital of fudan university and survival more than 3 years and the control group were diagnosised Nasopharyngeal Carcinoma newly and had nothing treatment.We also detected the coherent factors for carotid stenosis such as sex,age,blood glucose,blood cholesterol,blood vessel and smoking history.METHODS:The subjects were Nasopharyngeal Carcinoma patients.There are two groups in this study.Reserch group is composed of thirty patients whom received radiotherapy for the whole cervical part.and had survival more than 3 years.(22male and 8 female;mean age of 49.23 years) Including none ofâ… stage,11 patients ofâ…¡stage,16 patients ofâ…¢stage, 3 patients ofâ…£stage.Mean survival time was 39.7 months;the control group was composed of thirty Nasopharyngeal Carcinoma patients whom had received nothing treatment.(26 male and 4 female;mean age of 47.97 years)Including none ofâ… stage,14 patients ofâ…¡stage,13 patients ofâ…¢stage,3 patients ofâ…£stage.All patients were examined with color Doppler ultrasound to detect the carotid artery,including the common carotid artery,the internal carotid artery and the external carotid artery.The main index were diameter of carotid,intima-media thickness and the peak systolic and end diastolic velocities.Meanwhile,this study also analyze coherent factors for carotid stenosis such as sex,age,blood glucose,blood cholesterol,blood vessel and smoking history.Chi square test and Wilcoxon rank sum test were used.RESULTS:Arterial stenosis was,however,more common in the reserch group than the control group(80%vs20%P<0.001).The common and internal carotid arteries were most commonly involved(70%vs20%P<0.001 and 63.3%vs10%P<0.001),followed by the external carotid carotid artery(30%vss3.3%P=0.015).Significant stenosis(>50%reduction of luminal diameter)was only found in the research group(common carotid arteries 36.7%,internal carotid arteries23.3%,external carotid arteries 10%). There was no significant difference in the incidence of coherent factors such as sex,age,blood glucose,blood cholesterol,blood vessel and smoking history between the two groups.CONCLUSIONS:This study showed that radiation could cause significant carotid stenosis to Nasopharyngeal Carcinoma patients whom had received radiotherapy more than 3 years.Carotid stenosis developed more frequently in common carotid artery and internel carotid artery which side had received radiotherapy.Whether these coherent factors had analyze in this study could contribution to carotid stenosis should discuss continue...