脳研究ジャーナル

Association between head and neck radiotherapy and cerebrovascular disease

Abstract

Stefanie Mundnich

Radiotherapy plays a key role in the treatment of head and neck cancer, as a definitive treatment or in combination with chemotherapy and/or surgery. However it is related to an increased risk of cerebrovascular disease. It is thought that radiotherapy produces a radiation-induced vasculopathy with endothelial dysfunction, injury and occlusion of the vasa vaosrum, and accelerated atherosclerosis. This is represented by an increase in carotid intima media thickness seen in the first 7 years after radiotherapy, with a six fold increase in the incidence of ischemic stroke. There are some few instruments used to predict cerebrovascular disease, all having in common as negative risk factors: advanced-age, hypertension and high cholesterol on statin treatment. Regular follow up and appropriate screening for cerebrovascular disease are recuired for this population to prevent an ischemic stroke.