Postirradiated carotid blowout syndrome in patients with nasopharyngeal carcinoma: A case-control study

BackgroundCarotid blowout syndrome is one of the most devastating complications of nasopharyngeal carcinoma (NPC) therapy. MethodsA 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. ResultsWhen 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. ConclusionReirradiation 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. (c) 2014 Wiley Periodicals, Inc. Head Neck 37: 794-799, 2015