Neck Irradiation: A Risk for Carotid Atherosclerosis

Background: Radiation injury to the carotid arteries, with resultant stenosis and stroke, is a well-known long-term sequel for cervical radiotherapy (RT), the objective of the present study is to determine whether irradiation is an independent risk factor for carotid atherosclerosis and propose guidelines for patients follow-up. Design: A retrospective case control study. Patients and Methods: Tow groups of head and neck cancer patients matching in age, sex, smoking and incidence of diabetes mellitus and hypertension. Group I twenty eight post neck irradiation treated patients and a 22 cancer patients with no history of irradiation therapy (group II). Both groups subjected to physical examination, laboratory assessment including total lipid profile, fasting blood sugar and HbAIc. Carotid duplex study was done to all patients assessing intimamedia thickness, plaque existence and lumen reduction. Results: Patients in group I (radiotherapy treated cancer patients) show statistical significant difference in numbers of TIAs and the audible carotid bruit (p value 0.04). Measurement of Intima-Media thickness by carotid duplex show statistical significant increase in thickness in group I compared to group II (p value 0.001). Conclusion: Neck irradiation should be considered a risk factor for occlusive carotid artery disease and yearly duplex scanning follow-up for all patients after neck irradiation is recommended.