Low-density lipoprotein cholesterol and radiotherapy-induced carotid atherosclerosis in subjects with head and neck cancer.

Eduardo B Pereira,Andrei C Sposito,Wilson Nadruz Jr,José R Matos-Souza,Tiago Gemignani

doi:10.1186/1748-717x-9-134

Eduardo B Pereira, Andrei C Sposito + Show 3 more

Open Access

https://doi.org/10.1186/1748-717x-9-134

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Abstract

BackgroundRadiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer. However, the risk factors of RT-induced carotid artery remodeling are not established. This study aimed to investigate the effects of RT on carotid and popliteal arteries in subjects with head and neck cancer and to evaluate the relationship between baseline clinical and laboratory features and the progression of RT-induced atherosclerosis.FindingsEleven men (age = 57.9 ± 6.2years) with head and neck cancer who underwent cervical bilateral irradiation were prospectively examined by clinical and laboratory analysis and by carotid and popliteal ultrasound before and after treatment (mean interval between the end of RT and the post-RT assessment = 181 ± 47 days). No studied subject used hypocholesterolemic medications. Significant increases in carotid intima-media thickness (IMT) (0.95 ± 0.08 vs. 0.87 ± 0.05 mm; p < 0.0001) and carotid IMT/diameter ratio (0.138 ± 0.013 vs. 0.129 ± 0.014; p = 0.001) were observed after RT, while no changes in popliteal structural features were detected. In addition, baseline low-density lipoprotein cholesterol levels showed a direct correlation with RT-induced carotid IMT change (r = 0.66; p = 0.027), while no other studied variable exhibited a significant relationship with carotid IMT change.ConclusionsThese results indicate that RT-induced atherosclerosis is limited to the irradiated area and also suggest that it may be predicted by low-density lipoprotein cholesterol levels in subjects with head and neck cancer.

Highlights

Radiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer
These results indicate that RT-induced atherosclerosis is limited to the irradiated area and suggest that it may be predicted by low-density lipoprotein cholesterol levels in subjects with head and neck cancer
Radiotherapy (RT) is a risk factor for stroke in patients treated for head and neck cancer [1] and the major underlying mechanism of this association is the development of carotid artery atherosclerotic disease secondary to local radiation exposition [1,2]

Summary

Introduction

Radiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer. Radiotherapy (RT) is a risk factor for stroke in patients treated for head and neck cancer [1] and the major underlying mechanism of this association is the development of carotid artery atherosclerotic disease secondary to local radiation exposition [1,2]. Subjects with cancer have been reported to present accelerated atherosclerosis even in the absence of radiation exposition [11]. This body of evidence raises the hypothesis that arterial remodeling could be not restricted to irradiated areas in subjects with cancer

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