engleski

Association between Framingham cardiovascular risk score (FCRS) and carotid artery stenosis in patients having received radiotherapy for laryngeal carcinoma

Background and purpose:Carotid artery stenosis (CAS) is one of the major complications of external irradiation therapy (radiotherapy, XRT) for laryngeal carcinoma. Prevalence of carotid arterial disease in patients with previous cervical radiation therapy is high enough to justify routine screening for carotid artery stenosis.Methods: 42 post-irradiation patients (33 male and 9 female: mean age 53.6 years) with laryngeal carcinoma were examined with Color Duplex Doppler Ultrasound in the neurosonology Laboratory, Neurology Department, Clinical Hospital of Rijeka. The mean follow-up time after radiotherapy in the RT group was 5.2 years and the mean dosage of irradiation was 6000cGy in the neck area. Detailed review of cerebrovascular risk factors – such as hypertension, smoking, diabetes and hypercholesterolemia in these two groups were also monitored. Framingham cardiovascular risk score (FCRS) using age and gender adjustment were recorded for each individual. They were divided into low, intermediate, and high 10 year Framingham CHD risk score categories.Resultus: Duplex ultrasound scans revealed that 14 (33.33%) patients had significant radiation-induced carotid artery stenosis. 5(11.9%) patients had unilateral carotid occlusion, and 4 patients (9.52%) had a stroke after radiation therapy. All the patients with radiation-induced CAS are associatied with higher risk FCRS categories.Conclusion: The study has shown that radiation could cause significant carotid stenosis. That is why aggressive surveillance is recommended as well as yearly ultrasound examinations of RT patients for screening and early detection of radiation-induced carotid stenosis especially with patients in high risk FCRS categories.

Carotid artery stenosis; radiotherapy; laryngeal carcinoma; Framingham cardiovascular risk score

nije evidentirano