Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2025, Vol. 39 ›› Issue (4): 77-84.doi: 10.6040/j.issn.1673-3770.0.2025.156

• Clinical Research • Previous Articles     Next Articles

Computed tomography angiography-based assessment of internal carotid artery stenosis after radiotherapy for nasopharyngeal carcinoma and its associated factors

ZHU Ruikai1,2, WU Jiarong1, SUN Fang1,3, XIE Chubo2, QIU Qianhui1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Guangdong Provincial People's Hospital (Guanadong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, Guangdong, China2. Department of Otorhinolaryngology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai 519000, Guangdong, China3. Shantou University Medical College, Shantou 515041, Guangdong, China
  • Online:2025-07-20 Published:2025-08-11

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Abstract: Objective To investigate the incidence and risk factors of internal carotid artery(ICA)stenosis after radiotherapy for nasopharyngeal carcinoma(NPC)based on computed tomography angiography(CTA)evaluation, and to provide a basis for early screening and intervention. Methods Clinical data of 151 NPC patients who underwent radiotherapy and were admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital, between February 2018 and November 2022, were retrospectively analyzed. All patients underwent head and neck CTA to assess ICA stenosis. Patients were categorized into a normal group(no stenosis, n=77)and an abnormal group(including mild, moderate, severe stenosis, or complete occlusion, n=74)based on post-radiotherapy ICA status. Clinical characteristics were compared between these groups, and Logistic regression analysis was used to identify potential influencing factors, such as gender, age, hypertension, diabetes mellitus, hyperlipidemia, smoking history, post-radiotherapy interval, radiotherapy course, and TNM staging. Results Among the 151 NPC patients after radiotherapy, ICA stenosis severity was evaluated using the North American Symptomatic Carotid Endarterectomy Trial(NASCET)method. The distribution was as follows: no stenosis accounted for 50.99%, mild stenosis for 12.58%, moderate stenosis for 27.15%, severe stenosis for 5.31%, and complete occlusion for 3.97%. Univariate analysis revealed statistically significant differences between the normal and abnormal groups in terms of gender, age distribution, presence or absence of hypertension, smoking history, post-radiotherapy interval, radiotherapy course, and TNM stage(P<0.05). Logistic regression analysis indicated that age(51-70 years)(OR=7.917, 95%CI: 5.913-9.921), female gender(OR=3.394, 95%CI: 1.980-4.808), hypertension(OR=2.872, 95%CI: 1.640-4.104), smoking history(OR=2.219, 95%CI: 1.103-3.335), post-radiotherapy interval(>10 years)(OR=4.125, 95%CI: 2.081-6.169), re-irradiation(OR=5.912, 95%CI: 4.474-7.350), and local/regional recurrence(OR=3.056, 95%CI: 1.790-4.332)were all identified as independent risk factors significantly associated with ICA stenosis in NPC patients after radiotherapy(P< 0.05). Conclusion Regular screening for ICA stenosis is recommended for NPC survivors, especially those aged >50 years, female, with hypertension, a history of smoking, a post-radiotherapy interval >10 years, undergoing re-irradiation, or experiencing local/regional recurrence, to enable early intervention and improve prognosis and quality of life.

Key words: Nasopharyngeal Carcinoma, Radiation Therapy, Internal Carotid Artery Stenosis, Computed Tomography Angiography

CLC Number: 

  • R739.63
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