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Postirradiated carotid blowout syndrome in patients with nasopharyngeal carcinoma: a case-control study
Kun-Chih Chen1, Ting-Ting Yen1, Yi-Ling Hsieh1
1Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.
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.
