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Radiation Oncology
Published in: Radiation Oncology 1/2013

Open Access 01-12-2013 | Research

A simple strategy to decrease fatal carotid blowout syndrome after stereotactic body reirradiaton for recurrent head and neck cancers

Authors: Gozde Yazici, Tolga Yusuf Sanlı, Mustafa Cengiz, Deniz Yuce, Melis Gultekin, Pervin Hurmuz, Ferah Yıldız, Faruk Zorlu, Fadil Akyol, Murat Gurkaynak, Gokhan Ozyigit

Published in: Radiation Oncology | Issue 1/2013

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Abstract

Background

This study aimed to compare the therapeutic outcomes and fatal carotid blow out syndrome (CBOS) incidence rates between two different stereotactic body radiotherapy (SBRT) protocols.

Methods

The study included 75 patients with inoperable locally recurrent head and neck cancer treated with SBRT in our department between June 2007 and March 2011. The first 43 patients were treated sequentially (group I). Then our SBRT protocol was changed due to the high rate of CBOS, and the following 32 patients were treated every other day in a prospective institutional protocol (group II).

Results

Median overall survival in group I and group II was 11 months and 23 months, respectively (P = 0.006). We observed 11 cases of CBOS. Only 1 of 7 patients (14%) with CBOS survived in group I, whereas 2 of 4 patients (50%) in group II remain alive. CBOS free median overall survivals were 9 months, and 23 months in group I and group II respectively (P = 0.002). The median radiation dose received by the carotid artery in patients with CBOS was 36.5 Gy (range: 34–42.8 Gy), versus 34.7 Gy (range: 0–44 Gy) in the patients that didn’t have CBOS (P = 0.15). CBOS did not occur in any of the patients with a maximum carotid artery radiation dose <34 Gy.

Conclusions

Every other day SBRT protocol for re-irradiation of recurrent head and neck cancer is promising in terms of decreasing the incidence of fatal CBOS.
Appendix
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Metadata
Title
A simple strategy to decrease fatal carotid blowout syndrome after stereotactic body reirradiaton for recurrent head and neck cancers
Authors
Gozde Yazici
Tolga Yusuf Sanlı
Mustafa Cengiz
Deniz Yuce
Melis Gultekin
Pervin Hurmuz
Ferah Yıldız
Faruk Zorlu
Fadil Akyol
Murat Gurkaynak
Gokhan Ozyigit
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2013
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-8-242

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