Kun-Chih Chen1, Ting-Ting Yen1, Yi-Ling Hsieh1, Hung-Chieh Chen2, Rong-San Jiang1,3, Wen-Hsien Chen2, Kai-Li Liang1,3,4. 1. Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan. 2. Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan. 3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan. 4. Department of Medicine, National Yang-Ming Medical University, Taipei, Taiwan.
Abstract
BACKGROUND: Carotid blowout syndrome is one of the most devastating complications of nasopharyngeal carcinoma (NPC) therapy. METHODS: A retrospective review was conducted from January 2004 to April 2013. Thirty-one patients with carotid blowout syndrome were enrolled and a case control study was conducted to analyze the risk factors. RESULTS: When a comparison was made between the carotid blowout syndrome and matched non-bleeding group, there was a significantly higher local recurrence rate and prevalence of skull base osteoradionecrosis (ORN) in the carotid blowout syndrome group compared to those of the control group (both p < .001). The hazard ratio of carotid blowout syndrome was 3.599 between patients with or without reirradiation (95% confidence interval, 1.465-8.839; p = .005, adjusted for nasopharyngectomy and chemotherapy) using a Cox proportional hazard model. CONCLUSION: Reirradiation and skull base ORN are strong predisposing factors for carotid blowout syndrome, and therefore they should be mentioned in the informed consent form before treatment.
BACKGROUND: Carotid blowout syndrome is one of the most devastating complications of nasopharyngeal carcinoma (NPC) therapy. METHODS: A retrospective review was conducted from January 2004 to April 2013. Thirty-one patients with carotid blowout syndrome were enrolled and a case control study was conducted to analyze the risk factors. RESULTS: When a comparison was made between the carotid blowout syndrome and matched non-bleeding group, there was a significantly higher local recurrence rate and prevalence of skull base osteoradionecrosis (ORN) in the carotid blowout syndrome group compared to those of the control group (both p < .001). The hazard ratio of carotid blowout syndrome was 3.599 between patients with or without reirradiation (95% confidence interval, 1.465-8.839; p = .005, adjusted for nasopharyngectomy and chemotherapy) using a Cox proportional hazard model. CONCLUSION: Reirradiation and skull base ORN are strong predisposing factors for carotid blowout syndrome, and therefore they should be mentioned in the informed consent form before treatment.
Authors: S Stacchiotti; A Gronchi; P Fossati; T Akiyama; C Alapetite; M Baumann; J Y Blay; S Bolle; S Boriani; P Bruzzi; R Capanna; A Caraceni; R Casadei; V Colia; J Debus; T Delaney; A Desai; P Dileo; S Dijkstra; F Doglietto; A Flanagan; S Froelich; P A Gardner; H Gelderblom; Z L Gokaslan; R Haas; C Heery; N Hindi; P Hohenberger; F Hornicek; R Imai; L Jeys; R L Jones; B Kasper; A Kawai; M Krengli; A Leithner; I Logowska; J Martin Broto; D Mazzatenta; C Morosi; P Nicolai; O J Norum; S Patel; N Penel; P Picci; S Pilotti; S Radaelli; F Ricchini; P Rutkowski; S Scheipl; C Sen; E Tamborini; K A Thornton; B Timmermann; V Torri; P U Tunn; M Uhl; Y Yamada; D C Weber; D Vanel; P P Varga; C L A Vleggeert-Lankamp; P G Casali; J Sommer Journal: Ann Oncol Date: 2017-06-01 Impact factor: 32.976
Authors: Carlos Suárez; Verónica Fernández-Alvarez; Marc Hamoir; William M Mendenhall; Primoz Strojan; Miquel Quer; Carl E Silver; Juan P Rodrigo; Alessandra Rinaldo; Alfio Ferlito Journal: Cancer Manag Res Date: 2018-11-13 Impact factor: 3.989