Carotic blowout syndromeCarotid blowout syndrome in pharyngeal cancer patients treated by hypofractionated stereotactic re-irradiation using CyberKnife: A multi-institutional matched-cohort analysis
Section snippets
Materials and methods
The medical records of patients who underwent CyberKnife SBRT (Accuray; Sunnyvale, CA, USA) at four hospitals (Soseikai General Hospital, Osaka University Hospital, Fujimoto Hayasuzu Hospital, and Okayama Kyokuto Hospital) during 2000–2010 were reviewed for inclusion into the study. Among the 209 head and neck cancer patients who received reirradiation for residual, recurrent, or secondary malignancies, those with recurrent pharyngeal tumors adjacent to the carotid artery were included in this
Results
The median follow up time for the surviving patients after SBRT was 21 months (range, 6–122 months). No statistically significant deviation in sex, age, site, and treatment schedule was observed between the CBOS and non-CBOS cases (Table 1). The median duration between reirradiation and CBOS onset was 5 months (range, 0–69 months). There were significant differences in median survival time and 1-year survival rates between the CBOS and non-CBOS cases (5.5 vs. 22.8 months and 36% vs.72%; p = 0.005),
Discussion
CBOS is one of the most devastating complications of head and neck cancer. It generally occurs as a postoperative complication or when the tumor compromises the vascular axis [11]. CBOS is most common in patients who have previously received radiotherapy and/or underwent surgery [3], [12], and it also occurs after initial chemoradiation [11]. Other reported risk factors for CBOS are infection, pharyngocutaneous fistula formation, tumor progression, diffuse mucosal involvement/ulceration, and
Declaration of interests
We declare no competing interests.
Acknowledgement
We appreciate to Professor Satoshi Teramukai for his valuable assistance and supervision for statistical analyze. We also thank Enago (www.enago.jp) for the English language review.
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