Introduction: Survivors of Hodgkin lymphoma are recognized to have an increased risk of stroke and carotid artery disease owing to neck irradiation (RT). However, it remains unclear whether the vascular modifications induced by the treatment of Hodgkin lymphoma during childhood persist over the long term. Methods: Our matched study involved 79 survivors of Hodgkin lymphoma in childhood who received neck RT and 57 healthy controls. Parameters of arterial stiffness (AS), intima-media thickness (IMT), and flow-mediated dilation (FMD) of carotid arteries were assessed using ultrasound. Results: Our patient cohort demonstrated a significant increase in AS compared to controls (p< 0.05), though no such disparity was observed for FMD (p= 0.111). Neck RT intensified AS (B = 0.037,p= 0.000), while anthracyclines attenuated it (B = −0.803,p= 0.000). Multivariate analysis revealed a positive correlation between neck RT (p< 0.001) and AS. However, we found no significant association between neck RT and FMD (p= 0.277). We identified a substantial positive correlation between the dose of neck RT and AS. Conclusions: Vascular changes in survivors of childhood Hodgkin lymphoma after neck RT seem to be long-term. Therefore, these patients may have an increased risk of stroke. We suggest refinement of international guidelines according to our results.
引言：霍奇金淋巴瘤幸存者因颈部放疗（RT）导致中风和颈动脉疾病风险增加已被证实。然而，目前尚不清楚儿童时期接受霍奇金淋巴瘤治疗引起的血管改变是否具有长期持续性。方法：本匹配研究纳入79例儿童期接受颈部放疗的霍奇金淋巴瘤幸存者和57名健康对照者。通过超声评估动脉僵硬度（AS）、颈动脉内膜中层厚度（IMT）和流动介导的血管舒张功能（FMD）。结果：患者组动脉僵硬度显著高于对照组（p<0.05），但FMD未见显著差异（p=0.111）。颈部放疗加剧动脉僵硬度（B=0.037，p=0.000），而蒽环类药物具有减弱作用（B=-0.803，p=0.000）。多变量分析显示颈部放疗与动脉僵硬度呈正相关（p<0.001），但颈部放疗与FMD无显著关联（p=0.277）。研究发现颈部放疗剂量与动脉僵硬度存在显著正相关。结论：儿童期霍奇金淋巴瘤颈部放疗后幸存者的血管改变具有长期持续性，提示其可能面临更高的中风风险。建议根据本研究结果改进国际诊疗指南。
肿瘤(癌症)患者之家