Asymptomatic carotid arterial disease in young patients following neck radiation therapy for Hodgkin lymphoma

PURPOSE: To determine the prevalence and severity of asymptomatic carotid a rterial disease in young patients following neck radiation therapy for Hodg kin lymphoma and to compare the prevalence of carotid arterial disease foll owing radiation therapy alone with that following radiation;therapy;ind che motherapy. MATERIALS AND METHODS: Forty-two survivors of childhood or early adult Hodg kin lymphoma aged 18-37 years who had undergone radiation therapy more than 5 years earlier underwent carotid arterial ultrasonography. Common carotid intima-media thickness was measured; carotid vessels were assessed for int ima-media abnormalities. Results were compared with those from 33 control s ubjects. RESULTS: Patients had a significantly greater number of abnormal scans than did control subjects (11 [26%] vs one [3%]; P < .01). Ten patients(24%) ha d intima-media abnormalities that did not cause significant stenosis; one p atient had diffuse bilateral intima-media thickening (mean, 1.99 mm) with g reater than 70% stenosis of both common carotid arteries. Intima-media thic kness was significantly greater in patients (0.51 mm) than in control subje cts (0.43 mm; P < .005). The number of abnormalities in patients with radia tion therapy plus chemotherapy (six [19%] of 31 patients) did not differ si gnificantly from the number:in patients with only radiation therapy (five [ 45%] of 11 patients; P = .12); there was no significant difference between median intima-media thicknesses (0.50 mm vs 0.51 mm, P > .2). CONCLUSION: Asymptomatic carotid arterial disease occurs frequently in youn g patients following neck radiation therapy for Hodgkin lymphoma. No differ ence in prevalence was shown between only radiation therapy and radiation t herapy plus chemotherapy.