Carotid Artery Stenosis in Patients Treated for Head and Neck Cancer: A Community Based Retrospective Analysis

Author Info

Aaron E Wagner John S Goodman Brian J Mitchell Christopher M Lee Howard R Sanders Jason Call Jeffrey D Bunn Robert K Fairbanks Ryan Nachreiner Wayne T Lamoreaux

Corresponding Author

Jason Call
Alaska Cancer Treatment Center, Anchorage, AK, USA

A B S T R A C T

Purpose Radiotherapy treatment to the head and neck region is associated with a higher risk of developing carotid artery stenosis (CAS). This increases the patient’s risk for future cerebral vascular events such as stroke or transient ischemic attacks. We performed a community based observational retrospective study of CAS in patients who received surgical and/or radiation therapy treatment for head and neck malignancies. Methods and Material This study is a retrospective two-site institutional study. Data from 170 patients were obtained from Sacred Heart Hospital and Holy Family Hospital in Spokane, WA, USA between 2004 and 2007. A Fisher’s exact test was used to determine the prevalence of post-treatment CAS in patients who received radiotherapy and those who received surgery alone. Results One hundred and seventy patients met the inclusion criteria for this study. Thirty patients received surgery alone, 80 patients received radiation alone, and 60 received radiation plus surgery. Patients who received radiation therapy (radiation alone and radiation plus surgery groups) had a rate of any CAS of 17.9%, while those who received surgery alone had a rate of 13.3% (P = 0.789). Comparing patients who received radiation therapy to those who received surgery alone revealed rates of clinically significant CAS of 14.2% and 10.0%, respectively (P = 0.770). There were seven cases of severe CAS, all occurring in patients who received radiation. Conclusions Our study revealed nominally higher rates of CAS in patients who received radiotherapy for head and neck cancer. CAS is associated with an increased risk of harmful cerebrovascular events such as stroke and transient ischemic attack. A “gold standard” screening algorithm and management protocol has not yet been established for these patients. Thus, more research is needed to establish a “gold standard” screening algorithm for asymptomatic CAS in head and neck cancer survivors who have received therapeutic radiotherapy treatment.

Article Info

Article Type

Research Article

Publication history

Received: Fri 27, Apr 2018
Accepted: Mon 07, May 2018
Published: Tue 22, May 2018

Copyright

© 2023 Jason Call. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.COR.2018.10.012