Progression of carotid intima media thickness after radiotherapy: A long-term prospective cohort study

Joyce Wilbers*, Lucille D. Dorresteijn, Roy Haast, Frank J. Hoebers, Johannes H. Kaanders, Willem Boogerd, Erik D. van Werkhoven, Marlies E. Nowee, Hendrik H. G. Hansen, Chris L. de Korte, Arnoud C. Kappelle, Ewoud J. van Dijk

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and purpose: Carotid artery vasculopathy is a long-term complication of radiotherapy (RT) of the neck. We investigated the change in carotid intima media thickness (IMT) and the incidence of ischemic stroke in the first 7 years after radiotherapy (RT) of the neck. Materials and methods: A multicentre prospective cohort study among patients treated for Head and Neck Cancer (HNC) assessed carotid IMT at baseline (before RT) and after a median of 7 years follow-up. We also screened for cerebrovascular risk factors and events. Results: 48 patients underwent IMT measurement at baseline and follow-up (median age 61 years, range 29-87). Mean IMT of the irradiated common carotid arteries was 0.64 mm at baseline and 0.74 mm at follow-up (p = 0.002). Mean delta IMT in the irradiated and non-irradiated common carotid arteries were 0.11 and 0.02 mm (p = 0.03). Incidence rate of stroke in our cohort, compared to the Dutch population was 8.9 versus 1.5 per 1.000 person years. Conclusions: IMT in irradiated carotid arteries was significantly increased in the first 7 years after RT. The incidence rate of stroke was six fold increased. Patients treated with RT for HNC have sustained risk for developing atherosclerosis of the carotid arteries and future stroke.
Original languageEnglish
Pages (from-to)359-363
JournalRadiotherapy and Oncology
Issue number3
Publication statusPublished - Dec 2014


  • Head and neck cancer
  • Intima media thickness
  • Cerebrovascular disease
  • Carotid artery
  • Radiation vasculopathy


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