Cargando…
Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer
Laryngeal preserving concurrent chemoradiation has been advocated for hypopharyngeal cancers. The use of radiotherapy (RT) in the larynx could lead to increased rates of radionecrosis. In this study, we investigated a rare but disastrous complication, carotid blow-out syndrome (CBS), related with th...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666214/ https://www.ncbi.nlm.nih.gov/pubmed/36397450 http://dx.doi.org/10.1097/MD.0000000000031391 |
_version_ | 1784831453807247360 |
---|---|
author | Padua, Paula Francezca Fang, Hsuan-Yeh Young, Chi-Kuan Yeh, Chih-Hua Lin, Chia-Chen Liao, Chun-Ta Chang, Tung-Chieh Joseph Tsao, Chung-Kan Huang, Shiang-Fu |
author_facet | Padua, Paula Francezca Fang, Hsuan-Yeh Young, Chi-Kuan Yeh, Chih-Hua Lin, Chia-Chen Liao, Chun-Ta Chang, Tung-Chieh Joseph Tsao, Chung-Kan Huang, Shiang-Fu |
author_sort | Padua, Paula Francezca |
collection | PubMed |
description | Laryngeal preserving concurrent chemoradiation has been advocated for hypopharyngeal cancers. The use of radiotherapy (RT) in the larynx could lead to increased rates of radionecrosis. In this study, we investigated a rare but disastrous complication, carotid blow-out syndrome (CBS), related with the persistent radionecrosis. Retrospective cohort study. This retrospective study enrolled hypopharyngeal cancer patients with biopsy-proven pharyngeal and laryngeal chondronecrosis (PLCRN), which was rated by the Chandler Grading System. From 2002 to 2018, a total of 346 hypopharygeal cancer patients received upfront radiation therapy, 13 PLCRN patients were identified in a rate of 3.8%. All PLRN patients received RT with a mean radiation dose of 70.81 ± 0.85 Gy. All patients had Chandler Grade IV at the time of presentation, which was a mean of 15.08 months (range: 5‐109 months) from the time of cancer diagnosis to PLCRN diagnosis. In 5 of the 13 PLCRN patients developed CBS. Three of the CBS originated from superior thyroid artery, one from lingual artery and one from the carotid artery. Three (60%) of the 5 CBS patients expired due to loss of airway and hemodynamic instability. Two (40%) were rescued by emergent airway secure and emergent angiographic embolization. Persistent PLCRN could lead to disastrous vascular complications. CBSs were demonstrated to be more frequently originated from the branches of carotid artery rather than carotid artery per se. Clinical alert with early airway protection could strive for time to do interventions and prevent mortalities. |
format | Online Article Text |
id | pubmed-9666214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-96662142022-11-16 Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer Padua, Paula Francezca Fang, Hsuan-Yeh Young, Chi-Kuan Yeh, Chih-Hua Lin, Chia-Chen Liao, Chun-Ta Chang, Tung-Chieh Joseph Tsao, Chung-Kan Huang, Shiang-Fu Medicine (Baltimore) 6000 Laryngeal preserving concurrent chemoradiation has been advocated for hypopharyngeal cancers. The use of radiotherapy (RT) in the larynx could lead to increased rates of radionecrosis. In this study, we investigated a rare but disastrous complication, carotid blow-out syndrome (CBS), related with the persistent radionecrosis. Retrospective cohort study. This retrospective study enrolled hypopharyngeal cancer patients with biopsy-proven pharyngeal and laryngeal chondronecrosis (PLCRN), which was rated by the Chandler Grading System. From 2002 to 2018, a total of 346 hypopharygeal cancer patients received upfront radiation therapy, 13 PLCRN patients were identified in a rate of 3.8%. All PLRN patients received RT with a mean radiation dose of 70.81 ± 0.85 Gy. All patients had Chandler Grade IV at the time of presentation, which was a mean of 15.08 months (range: 5‐109 months) from the time of cancer diagnosis to PLCRN diagnosis. In 5 of the 13 PLCRN patients developed CBS. Three of the CBS originated from superior thyroid artery, one from lingual artery and one from the carotid artery. Three (60%) of the 5 CBS patients expired due to loss of airway and hemodynamic instability. Two (40%) were rescued by emergent airway secure and emergent angiographic embolization. Persistent PLCRN could lead to disastrous vascular complications. CBSs were demonstrated to be more frequently originated from the branches of carotid artery rather than carotid artery per se. Clinical alert with early airway protection could strive for time to do interventions and prevent mortalities. Lippincott Williams & Wilkins 2022-11-11 /pmc/articles/PMC9666214/ /pubmed/36397450 http://dx.doi.org/10.1097/MD.0000000000031391 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. |
spellingShingle | 6000 Padua, Paula Francezca Fang, Hsuan-Yeh Young, Chi-Kuan Yeh, Chih-Hua Lin, Chia-Chen Liao, Chun-Ta Chang, Tung-Chieh Joseph Tsao, Chung-Kan Huang, Shiang-Fu Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer |
title | Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer |
title_full | Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer |
title_fullStr | Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer |
title_full_unstemmed | Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer |
title_short | Carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer |
title_sort | carotid arterial blowout after organ preserving chemoradiation therapy in hypopharyngeal cancer |
topic | 6000 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666214/ https://www.ncbi.nlm.nih.gov/pubmed/36397450 http://dx.doi.org/10.1097/MD.0000000000031391 |
work_keys_str_mv | AT paduapaulafrancezca carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT fanghsuanyeh carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT youngchikuan carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT yehchihhua carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT linchiachen carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT liaochunta carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT changtungchiehjoseph carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT tsaochungkan carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer AT huangshiangfu carotidarterialblowoutafterorganpreservingchemoradiationtherapyinhypopharyngealcancer |