- •Radiotherapy (RT) may cause stenosis of the carotid arteries.
- •RT patients showed a statistically significant higher incidence of overall stenosis.
- •Analyzing by individual vessels showed that the RT patients had higher incidence of stenosis.
- •NPC patients who receive RT have increased risk of developing carotid stenosis.
Radiotherapy (RT) is the most effective treatment for nasopharyngeal carcinoma (NPC) but may cause stenosis of the carotid arteries. This meta-analysis evaluates the prevalence of carotid stenosis after radiation therapy.
Materials and methods
Online search for studies reporting carotid stenosis in patients with NPC who received radiation therapy (RT) compared to NPC patients who did not receive RT and compared to healthy controls.
Twelve studies were included for a total analysis of 1928 patients (837 received RT and 1091 were controls). RT patients showed a statistically significant higher incidence of overall stenosis (pooled risk ratio = 4.17 [2.44, 7.10], p < 0.00001) and an even greater incidence of significant stenosis (50% or more) (pooled risk ratio = 8.72 [3.53, 21.55], p < 0.00001). Analyzing by individual blood vessels showed that the RT patients had significantly higher incidence of stenosis in common carotid artery (CCA), external carotid artery (ECA), carotid bulb, CCA and internal carotid artery (ICA), and CCA/ICA/carotid bulb.
NPC patients who receive RT have increased risk of developing carotid stenosis, and should be screened after treatment.
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Published online: February 04, 2019
Accepted: November 20, 2018
Received in revised form: November 11, 2018
Received: July 16, 2018
© 2018 Elsevier B.V. All rights reserved.