dc.contributor.author | Gujral, DM | |
dc.contributor.author | Shah, BN | |
dc.contributor.author | Chahal, NS | |
dc.contributor.author | Bhattacharyya, S | |
dc.contributor.author | Senior, R | |
dc.contributor.author | Harrington, KJ | |
dc.contributor.author | Nutting, CM | |
dc.date.accessioned | 2017-04-11T09:24:09Z | |
dc.date.issued | 2015-09-01 | |
dc.identifier.citation | QJM : monthly journal of the Association of Physicians, 2016, 109 (6), pp. 383 - 389 | |
dc.identifier.issn | 1460-2725 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/578 | |
dc.identifier.eissn | 1460-2393 | |
dc.identifier.doi | 10.1093/qjmed/hcv120 | |
dc.description.abstract | BACKGROUND: Primary radical radiotherapy (RT) for head and neck cancer (HNC) often results in significant radiation dose to the carotid arteries. AIM: We assessed whether HNC patients are at increased risk of a cerebrovascular event primarily due to RT or other risk factors for atherosclerosis by (i) risk-stratifying patients according to validated QRISK-2 and QSTROKE scores and (ii) comparing the prevalence of carotid artery stenosis (CAS) in irradiated and unirradiated carotid arteries. DESIGN: HNC patients treated with an RT dose >50 Gy to one side of the neck ≥2 years previously were included. METHODS: QRISK-2 (2014) and Q-STROKE (2014) scores were calculated. We compared the prevalence of CAS in segments of the common carotid artery on the irradiated and unirradiated sides of the neck. RESULTS: Fifty patients (median age of 58 years (interquartile range (IQR) 50-62)) were included. The median QRISK-2 score was 10% (IQR 4.4-15%) and the median QSTROKE score was 3.4% (IQR 1.4-5.3%). For both scores, no patient was classified as high risk. Thirty-eight patients (76%) had CAS in one or both arteries. There was a significant difference in the number of irradiated arteries with stenosis (N = 37) compared with unirradiated arteries (N = 16) (P < 0.0001). There were more plaques on the irradiated artery compared with the unirradiated side - 64/87 (73.6%) versus 23/87 (26.4%), respectively (P < 0.001). CONCLUSIONS: Traditional vascular risk factors do not play a role in radiation-induced carotid atherosclerosis. Clinicians should be aware that traditional risk prediction models may under-estimate stroke risk in these patients. | |
dc.format | Print-Electronic | |
dc.format.extent | 383 - 389 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER SCI LTD | |
dc.rights.uri | https://www.rioxx.net/licenses/all-rights-reserved | |
dc.subject | Carotid Arteries | |
dc.subject | Humans | |
dc.subject | Head and Neck Neoplasms | |
dc.subject | Carotid Artery Diseases | |
dc.subject | Radiation Injuries | |
dc.subject | Ultrasonography | |
dc.subject | Radiotherapy Dosage | |
dc.subject | Prevalence | |
dc.subject | Logistic Models | |
dc.subject | Risk Assessment | |
dc.subject | Risk Factors | |
dc.subject | Predictive Value of Tests | |
dc.subject | Middle Aged | |
dc.subject | Female | |
dc.subject | Male | |
dc.subject | Stroke | |
dc.title | Do traditional risk stratification models for cerebrovascular events apply in irradiated head and neck cancer patients? | |
dc.type | Journal Article | |
rioxxterms.versionofrecord | 10.1093/qjmed/hcv120 | |
rioxxterms.licenseref.uri | https://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2016-06 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | QJM : monthly journal of the Association of Physicians | |
pubs.issue | 6 | |
pubs.notes | 12 months | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Cancer Biology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Cancer Biology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.publication-status | Published | |
pubs.volume | 109 | |
pubs.embargo.terms | 12 months | |
icr.researchteam | Targeted Therapy | |
dc.contributor.icrauthor | Harrington, Kevin | |