Risk of Carotid Blowout After Reirradiation of the Head and Neck: A Systematic Review

McDonald, Mark W.; Moore, Michael G.; Johnstone, Peter A.S.

doi:10.1016/j.ijrobp.2010.08.029

Cited by 193 publications

(144 citation statements)

References 37 publications

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“…McDonald et al reported that there were 41 cases of CBS among 1554 cases that received salvage re-irradiation (2.6%). Of these, 76% were fatal [16]. Among patients treated with a continuous course of 1.8-2-Gy daily fractions or 1.2-Gy twice daily fractions, 36% received concurrent chemotherapy, and the rate of CBS was 1.3%.…”

Section: Discussionmentioning

confidence: 99%

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Yamazaki

Ogita²,

Kodani

et al. 2013

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Yamazaki

Ogita²,

Kodani

et al. 2013

Radiotherapy and Oncology

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“…In the literature, this duration varies from during radiotherapy to 17 years, but CBS was mostly seen in a year after radiotherapy. This variation suggests the possibility of having different pathways of underlying pathologic processes [4].…”

Section: Discussionmentioning

confidence: 99%

Carotid blowout syndrome after intensity-modulated radiation therapy: A case report

Sahin¹,

Atalar²,

Yakupoğlu³

et al. 2017

Marmara Medical Journal

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Carotid blowout syndrome (CBS) is a rarely seen complication of head-neck surgery and radiation therapy. It may present by massive ear bleeding or epistaxis with high morbidity and mortality rates. Success rate of endovascular therapy or emergency surgery is unfortunately low because of massive bleeding and weakened vessel architecture. Here, we present a 45-year-old male with nasopharyngeal carcinoma and treated with intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy. The patient was diagnosed with stage III (T3N2M0) carcinoma of the nasopharynx. Eight months after radiotherapy, he was admitted to hospital with the complaint of epistaxis. Right internal carotid angiography revealed a 4 mm pseudoaneurysm at the superioranterior wall of the petrous and his bleeding was controlled by stenting in the same session. In this report we aimed to draw attention to this rare clinical situation that might enhance the chance of early diagnosis enabling less morbid treatment opportunities. Keywords: IMRT, Carotid blowout syndrome, CBS, Pseudoaneurysm ÖZCarotid blowout sendromu (CBS) veya pseudoaneurysm, baş-boyun cerrahisi ve radyoterapi sonrası nadir görülen bir komplikasyondur. Yüksek morbidite ve mortalite oranları ile masif kulak kanaması veya epistaksis şeklinde görülür. Zayıflamış damar yapısı ve masif kanama sebebiyle acil cerrahi ya da endovasküler tedavilerin başarı şansı oldukça düşüktür. Bu yazıda, nazofarenks kanseri tanısı olan ve eş zamanlı kemoterapi ile beraber yoğunluk ayarlı radyoterapi (YART) C alan 3. evre (T3N2M0), 45 yaşında erkek hasta sunulmuştur. Radyoterapi sonrası 8. ayda epistaksis ile hastaneye başvuran hastanın sağ internal carotis arter anjiografisinde petros segmentin antero-superior duvarında 4mm pseudoanevrizma saptanıp aynı seansta stentle kanama kontrolu yapılmıştır. Bu yazıda, erken tanı konulabilmesi ve dolayısıyla daha az morbid tedavi seçeneklerinin sunulabilmesi için nadir görülen bu klinik duruma dikkat çekilmesi amaçlanmıştır.

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“…CBS is more frequent in cases of radiation induced necrosis, recurrent tumours, wound complications from neck dissection, or vessel erosion from pharyngocutaneous fistulas. Carotid blowout syndrome (CBS) resulting from radiotherapy alone is an uncommon complication and is usually associated with sudden, catastrophic bleeding [2][3][4]. The mortality rate was reported to range from 3% to over 50% in the literature [5].…”

Section: Introductionmentioning

confidence: 99%

“…The mortality rate was reported to range from 3% to over 50% in the literature [5]. Therefore, in a recent meta-analysis, the mortality rate of carotid blowout after re-irradiation in those patients treated by head and neck tumours was as high as 76% [2]. Direct surgical repair of the ruptured internal carotid artery is often not technically possible due to the difficult anatomy and underlying poor co-morbid status [5,6].…”

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment for Carotid Blowout Syndrome after Radiation: A Case Report

Rodrigues¹,

Costa²,

Roriz³

et al. 2017

J Cancer Sci Ther

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Carotid blowout syndrome is one of the most complex bleeding complications that may occur in head and neck cancers patients. The purpose of this paper is to report the clinical manifestations and endovascular management of a case of patient with neck malignancies and a history of radiotherapy. The patient underwent immediate covered stent deployment which resulted in the successful control of bleeding.

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Risk of Carotid Blowout After Reirradiation of the Head and Neck: A Systematic Review

Cited by 193 publications

References 37 publications

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study

Carotid blowout syndrome after intensity-modulated radiation therapy: A case report

Endovascular Treatment for Carotid Blowout Syndrome after Radiation: A Case Report

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