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Postirradiated carotid blowout syndrome in patients with nasopharyngeal carcinoma: A case–control study
Author(s) -
Chen KunChih,
Yen TingTing,
Hsieh YiLing,
Chen HungChieh,
Jiang RongSan,
Chen WenHsien,
Liang KaiLi
Publication year - 2015
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23671
Subject(s) - medicine , nasopharyngeal carcinoma , osteoradionecrosis , hazard ratio , confidence interval , surgery , skull , proportional hazards model , radiation therapy
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. © 2014 Wiley Periodicals, Inc. Head Neck 37: 794–799, 2015