Next Article in Journal
The BRCA Gene in Epithelial Ovarian Cancer
Next Article in Special Issue
Phase II Trial of CDX-3379 and Cetuximab in Recurrent/Metastatic, HPV-Negative, Cetuximab-Resistant Head and Neck Cancer
Previous Article in Journal
Role of the Skin Microenvironment in Melanomagenesis: Epidermal Keratinocytes and Dermal Fibroblasts Promote BRAF Oncogene-Induced Senescence Escape in Melanocytes
 
 
Article

Radiotherapy Is Associated with an Accelerated Risk of Carotid Atherosclerosis in Patients with Nasopharyngeal Carcinoma: A Nine-Year Prospective Follow-Up Study

1
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung City 83301, Taiwan
2
Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
3
Department of Biological Science, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
4
Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen 361126, China
5
Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
6
Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
7
Department of Otorhinolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
8
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
These authors contributed equally to this work.
Academic Editor: Primož Strojan
Cancers 2022, 14(5), 1234; https://doi.org/10.3390/cancers14051234
Received: 20 December 2021 / Revised: 21 February 2022 / Accepted: 25 February 2022 / Published: 27 February 2022
(This article belongs to the Special Issue Precision Medicine for Head and Neck Cancer)
Radiotherapy has become a common treatment modality for nasopharyngeal carcinoma, and concurrent chemoradiation therapy prolongs the survival of patients. Radiotherapy leads to the increased generation of reactive oxygen species and free radicals to destroy abnormal cell growths within normal cell environmental conditions. However, the late effects on “bystander” organs (e.g., extracranial arteries) among survivors after radiotherapy have become increasingly prevalent. This study showed radiation-related extracranial vasculopathy is a progressive process that begins immediately after radiotherapy with significantly increased carotid IMT compared to the control group during the 9-year follow-up. Chronic inflammation and oxidative stress might serve to drive the process and also contribute to increased platelet activation.
Radiation-related extracranial vasculopathy is a common late effect after radiation in patients with nasopharyngeal carcinoma (NPC). We proposed the hypothesis that radiation-related extracranial vasculopathy is a progressive process that can begin immediately after radiotherapy and persist for a longer period, and inflammation and oxidative stress may play a pivotal role in this process. Thirty-six newly diagnosed NPC patients were assessed with B-mode ultrasound for the common carotid artery (CCA) intima media thickness (IMT) measurement as well as surrogate markers at three different stages (baseline, immediately after concurrent chemoradiation therapy (CCRT), and 9 years after enrollment). A healthy control group was also recruited for comparison. Surrogate markers including a lipid profile, HbA1c, inflammation, oxidative stress, and platelet activation markers were assessed. The mean CCA IMT in the NPC group were increased immediately after CCRT (p = 0.043). The mean CCA IMT value after a 9-year follow-up also showed a significant increase in NPC and control group, respectively (p < 0.0001 and p < 0.0001, paired t test). The annual increase mean CCA IMT (mm) was 0.053 ± 0.025 and 0.014 ± 0.013 in NPC and control group, respectively (p < 0.0001). The baseline high sensitivity CRP (hs-CRP), thiol, TBARS, and CD63 level were significantly higher in the NPC group (hs-CRP, p = 0.001, thiol, p < 0.0001, TBARS, p = 0.05, and CD63 level, p = 0.04). The thiol and TBARS levels were significantly lower in NPC patients immediately after CCRT (thiol, p < 0.0001, and TBARS, p = 0.043). The CD62P level was significantly higher while the thiol level was significantly lower in the NPC group after a 9-year follow-up (CD62P level, p = 0.007; and thiol level, p = 0.004). Radiation-related extracranial vasculopathy is a progressive process that begins immediately after radiotherapy with significantly increased carotid IMT compared to the control group during the 9-year follow-up. Chronic inflammation and oxidative stress might serve to drive the process and also contribute to increased platelet activation. View Full-Text
Keywords: atherosclerosis; inflammation; nasopharyngeal carcinoma; oxidative stress and radiotherapy; platelet activation atherosclerosis; inflammation; nasopharyngeal carcinoma; oxidative stress and radiotherapy; platelet activation
Show Figures

Figure 1

MDPI and ACS Style

Lu, C.-H.; Lai, Y.-R.; Fang, F.-M.; Tan, T.-Y.; Chiu, W.-C.; Hsieh, D.-Y.; Huang, C.-C.; Lien, C.-Y.; Cheng, B.-C.; Chien, C.-Y.; Huang, T.-L.; Kung, C.-T. Radiotherapy Is Associated with an Accelerated Risk of Carotid Atherosclerosis in Patients with Nasopharyngeal Carcinoma: A Nine-Year Prospective Follow-Up Study. Cancers 2022, 14, 1234. https://doi.org/10.3390/cancers14051234

AMA Style

Lu C-H, Lai Y-R, Fang F-M, Tan T-Y, Chiu W-C, Hsieh D-Y, Huang C-C, Lien C-Y, Cheng B-C, Chien C-Y, Huang T-L, Kung C-T. Radiotherapy Is Associated with an Accelerated Risk of Carotid Atherosclerosis in Patients with Nasopharyngeal Carcinoma: A Nine-Year Prospective Follow-Up Study. Cancers. 2022; 14(5):1234. https://doi.org/10.3390/cancers14051234

Chicago/Turabian Style

Lu, Cheng-Hsien, Yun-Ru Lai, Fu-Min Fang, Teng-Yeow Tan, Wen-Chan Chiu, Dong-Yi Hsieh, Chih-Cheng Huang, Chia-Yi Lien, Ben-Chung Cheng, Chih-Yen Chien, Tai-Lin Huang, and Chia-Te Kung. 2022. "Radiotherapy Is Associated with an Accelerated Risk of Carotid Atherosclerosis in Patients with Nasopharyngeal Carcinoma: A Nine-Year Prospective Follow-Up Study" Cancers 14, no. 5: 1234. https://doi.org/10.3390/cancers14051234

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop