Assessing the short-term effects of radiotherapy on the shear modulus of the common carotid artery as a new biomarker of radiation-induced atherosclerosis

Purpose@#The purpose of this study was to investigate the incidence of short-term atherosclerosis in the common carotid arteries following radiotherapy. @*Methods@#The mean radiation dose to the arteries was 49.30±15.83 Gy. A computational ultrasound method was introduced to investigate the elastic modulus. Ultrasonography was performed 2-3 cm inferior to the bifurcation region before and after radiotherapy, and sequential images were extracted from a video of each artery. Instantaneous movement of the arterial wall in the radial and longitudinal directions was extracted by implementing the maximum gradient and block matching algorithms, respectively. @*Results@#There was a significant change in systolic blood pressure after radiotherapy (P=0.008). Irradiated arteries had significantly smaller systolic and end-diastolic diameters than non-irradiated arteries (P<0.001). The shear modulus was significantly different between irradiated and non-irradiated arteries (3.10±2.03 kPa vs. 1.38±0.98 kPa, P<0.001). The shear and Young moduli of radiation-induced arteries were 2.25±1.50 and 1.57±0.59 times higher than those of the pre-irradiation arteries. @*Conclusion@#The arterial shear modulus can be considered as a new biomarker of radiationinduced atherosclerosis in the common carotid artery.

Hemodynamic analysis of radiation-induced damage in common carotid arteries by using color Doppler ultrasonography

PURPOSE: The aim of this study was to assess vascular changes and blood flow abnormalities in the common carotid arteries of patients with head and neck cancers after external radiotherapy, using color Doppler ultrasonography. METHODS: We studied 24 patients treated with external radiotherapy for various head and neck cancers. In order to study the acute effects of irradiation on common carotid blood flow and arterial diameter changes, color Doppler ultrasonography parameters such as peak systolic velocity, end diastolic velocity, mean velocity, systolic-to-diastolic velocity (S/D) ratio, pulsatility index (PI), resistive index (RI), and instantaneous diameter changes were evaluated before and after external radiotherapy. Additionally, the blood volume flow (VF) values in the peak systolic and end diastolic phases, as well as mean velocity, were evaluated throughout three cardiac cycles using B-mode ultrasonic image processing. RESULTS: The findings showed significant changes in the S/D ratio, PI, and RI of the common carotid arteries before and after external radiotherapy (P < 0.05). Moreover, a significant decrease in artery diameter and blood VF was observed after radiotherapy relative to the pretreatment values. A significant correlation was found between the blood VF values estimated using ultrasonic measurements and mathematical methods throughout three cardiac cycles. CONCLUSION: The hemodynamic parameters of the common carotid arteries changed during radiotherapy. These arterial changes may lead to late adverse effects of radiotherapy, such as ischemic strokes and ischemic attacks.

Effectiveness and complications of [153]Sm-EDTMP in palliative treatment of diffuse skeletal metastases

The aim of the present study was to evaluate the efficacy and safety profile of bone palliative therapy following administration of [153]Sm-EDTMP in patients with intractable metastatic bone pain. Sixteen patients [9 male, 7 female] aged 29-80 years [57.3 +/- 16.7 years] with severe metastasis-related bone pain resistant to analgesic medications were enrolled in the study. All patients having multiple bone metastases, positive bone scans, and estimated life expectancy of more than 2-3 months were entered the study. All patients received intravenous injection of 1.5 mCi [56 MBq]/kg of [153]Sm-EDTMP. Four subscales for the intensity of pain were recorded: one as the present pain score [PPS] and the other three as maximum pain score [Max PS], minimum pain score [Min PS] and average pain score [APS] over the last 24 hours. Also the mean value of these 4 subscales was calculated as the mean total pain score [MTPS]. The pain mental interference [PMI] was also assessed in 9 separate. Seven patients with breast cancer [43.75%], seven with prostate cancer [43.75%], one with papillary thyroid carcinoma [6.25%] and one with malignant paraganglioma [6.25%] were included in the study. A significant response to therapy, i.e. 2-point reduction in pain score and/or remarkable reduction [>/=25%] in the equivalent narcotic dose, was observed in 11 out of 16 patients [68.7%] by the 2nd week and in 12 patients [75%] by the 8[th] week. Regarding the palliative response to treatment and equivalent narcotic dose reduction, no significant difference between two major types of underlying malignancies [breast and prostate cancer] was found. There was no significant difference regarding response to therapy between two genders and among different age groups. The severity of bone marrow suppression was graded

Chemoradiation in nasopharyngeal carcinoma: a 6-year experience in Tehran cancer institute

To determine the addition of value of neoadjuvant, concurrent and adjuvant chemotherapy to radiation in the treatment of nasopharyngeal carcinoma with regard to the overall survival [OS] and disease free survival [DPS] within a six year period in Tehran cancer institute. Files of all patients with nasopharyngeal carcinoma treated by radiotherapy with or without concurrent chemotherapy in a curative setting in Tehran cancer institute during the period of 1999-2005 were retrospectively reviewed. A total of 103 patients with nasopharyngeal carcinoma had been treated during the study period with radiotherapy or chemoradiotherapy in our institute. There were 29 [28.2%] females and 74 [71.8%] males. The median age at the time of radiotherapy was 47 years old [range 9-75 years]. The patients were followed 2 to 76 months with a median follow-up of 14 months. Time of first recurrence after treatment was 3-44 months with a median of 10 months. Survival in 2 groups of patients treated with radiotherapy alone or chemoradiation did not have a significant difference [P>0.1]. Two-year survival in patients treated with or without adjuvant chemotherapy and had local recurrence after treatment did not have significant difference [P>0.1]. Two-year survival in patients with or without local recurrence after treatment did not have significant difference [P>0.1]. A beneficial effect or a survival benefit of adjuvant/neoadjuvant chemotherapy and concurrent chemoradiation was not observed in Iranian patients