Abstract
Purpose: Re-irradiation has attracted attention as a potential therapy for recurrent head and neck tumors. However, carotid blowout syndrome (CBS) has become a serious complication of re-irradiation because of the associated life-threatening toxicity. Determining of the characteristics of CBS is important. We conducted a multi-institutional study. Methods and patients: Head and neck carcinoma patients (n = 381) were treated with 484 re-irradiation sessions at 7 Japanese CyberKnife institutions between 2000 and 2010. Results: Of these, 32 (8.4%) developed CBS, which proved fatal that median survival time after CBS onset was 0.1 month, and the 1-year survival rate was 37.5%. The median duration between re-irradiation and CBS onset was 5 months (range, 0–69 months). Elder age, skin invasion, and necrosis/infection were identified as statistically significant risk factors after CBS by univariate analysis. The presence of skin invasion at the time of treatment found only in postoperative case, is identified as only statistically significant prognostic factor after CBS in multivariate analysis. The 1-year survival rate for the group without skin invasion was 42%, whereas no patient with skin invasion survived more than 4 months (0% at 1 year, p = 0.0049). Conclusions: Careful attention should be paid to the occurrence of CBS
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Yamazaki, Hideya;
[1]
CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)];
Ogita, Mikio;
[2]
Kodani, Naohiro;
[1]
CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)];
Nakamura, Satoakai;
[1]
Inoue, Hiroshi;
[3]
Himei, Kengo;
[4]
Kotsuma, Tadayuki;
Yoshida, Ken;
[5]
Yoshioka, Yasuo;
[6]
Yamashita, Koichi;
[7]
Udono, Hiroki
[8]
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine (Japan)
- Radiotherapy Department, Fujimoto Hayasuzu Hospital, Miyakonojo (Japan)
- CyberKnife Center, Kanto Neurosurgical Hospital, Kumagai (Japan)
- Department of Radiology, Japanese Red Cross Okayama Hospital (Japan)
- Department of Radiation Oncology, National Hospital Organization Osaka National Hospital (Japan)
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita (Japan)
- Tokyo CyberKnife Center, Oka Neurosurgical Clinic, Machida (Japan)
- Department of Neurosurgery, Tobata Kyoritsu Hospital, Kitakyusyu (Japan)
Citation Formats
Yamazaki, Hideya, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Ogita, Mikio, Kodani, Naohiro, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Nakamura, Satoakai, Inoue, Hiroshi, Himei, Kengo, Kotsuma, Tadayuki, Yoshida, Ken, Yoshioka, Yasuo, Yamashita, Koichi, and Udono, Hiroki.
Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study.
Ireland: N. p.,
2013.
Web.
doi:10.1016/J.RADONC.2013.05.005.
Yamazaki, Hideya, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Ogita, Mikio, Kodani, Naohiro, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Nakamura, Satoakai, Inoue, Hiroshi, Himei, Kengo, Kotsuma, Tadayuki, Yoshida, Ken, Yoshioka, Yasuo, Yamashita, Koichi, & Udono, Hiroki.
Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study.
Ireland.
https://doi.org/10.1016/J.RADONC.2013.05.005
Yamazaki, Hideya, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Ogita, Mikio, Kodani, Naohiro, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Nakamura, Satoakai, Inoue, Hiroshi, Himei, Kengo, Kotsuma, Tadayuki, Yoshida, Ken, Yoshioka, Yasuo, Yamashita, Koichi, and Udono, Hiroki.
2013.
"Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study."
Ireland.
https://doi.org/10.1016/J.RADONC.2013.05.005.
@misc{etde_22266997,
title = {Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study}
author = {Yamazaki, Hideya, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Ogita, Mikio, Kodani, Naohiro, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Nakamura, Satoakai, Inoue, Hiroshi, Himei, Kengo, Kotsuma, Tadayuki, Yoshida, Ken, Yoshioka, Yasuo, Yamashita, Koichi, and Udono, Hiroki}
abstractNote = {Purpose: Re-irradiation has attracted attention as a potential therapy for recurrent head and neck tumors. However, carotid blowout syndrome (CBS) has become a serious complication of re-irradiation because of the associated life-threatening toxicity. Determining of the characteristics of CBS is important. We conducted a multi-institutional study. Methods and patients: Head and neck carcinoma patients (n = 381) were treated with 484 re-irradiation sessions at 7 Japanese CyberKnife institutions between 2000 and 2010. Results: Of these, 32 (8.4%) developed CBS, which proved fatal that median survival time after CBS onset was 0.1 month, and the 1-year survival rate was 37.5%. The median duration between re-irradiation and CBS onset was 5 months (range, 0–69 months). Elder age, skin invasion, and necrosis/infection were identified as statistically significant risk factors after CBS by univariate analysis. The presence of skin invasion at the time of treatment found only in postoperative case, is identified as only statistically significant prognostic factor after CBS in multivariate analysis. The 1-year survival rate for the group without skin invasion was 42%, whereas no patient with skin invasion survived more than 4 months (0% at 1 year, p = 0.0049). Conclusions: Careful attention should be paid to the occurrence of CBS if the tumor is located adjacent to the carotid artery. The presence of skin invasion at CBS onset is ominous sign of lethal consequences.}
doi = {10.1016/J.RADONC.2013.05.005}
journal = []
issue = {3}
volume = {107}
journal type = {AC}
place = {Ireland}
year = {2013}
month = {Jun}
}
title = {Frequency, outcome and prognostic factors of carotid blowout syndrome after hypofractionated re-irradiation of head and neck cancer using CyberKnife: A multi-institutional study}
author = {Yamazaki, Hideya, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Ogita, Mikio, Kodani, Naohiro, CyberKnife Center, Soseikai General Hospital, Kyoto (Japan)], Nakamura, Satoakai, Inoue, Hiroshi, Himei, Kengo, Kotsuma, Tadayuki, Yoshida, Ken, Yoshioka, Yasuo, Yamashita, Koichi, and Udono, Hiroki}
abstractNote = {Purpose: Re-irradiation has attracted attention as a potential therapy for recurrent head and neck tumors. However, carotid blowout syndrome (CBS) has become a serious complication of re-irradiation because of the associated life-threatening toxicity. Determining of the characteristics of CBS is important. We conducted a multi-institutional study. Methods and patients: Head and neck carcinoma patients (n = 381) were treated with 484 re-irradiation sessions at 7 Japanese CyberKnife institutions between 2000 and 2010. Results: Of these, 32 (8.4%) developed CBS, which proved fatal that median survival time after CBS onset was 0.1 month, and the 1-year survival rate was 37.5%. The median duration between re-irradiation and CBS onset was 5 months (range, 0–69 months). Elder age, skin invasion, and necrosis/infection were identified as statistically significant risk factors after CBS by univariate analysis. The presence of skin invasion at the time of treatment found only in postoperative case, is identified as only statistically significant prognostic factor after CBS in multivariate analysis. The 1-year survival rate for the group without skin invasion was 42%, whereas no patient with skin invasion survived more than 4 months (0% at 1 year, p = 0.0049). Conclusions: Careful attention should be paid to the occurrence of CBS if the tumor is located adjacent to the carotid artery. The presence of skin invasion at CBS onset is ominous sign of lethal consequences.}
doi = {10.1016/J.RADONC.2013.05.005}
journal = []
issue = {3}
volume = {107}
journal type = {AC}
place = {Ireland}
year = {2013}
month = {Jun}
}