Carotid blowout syndrome after reirradiation for head and neck malignancies: a comprehensive systematic review for a pragmatic multidisciplinary approach

Daniela Alterio, Irene Turturici, Stefania Volpe, Annamaria Ferrari, Samuel William Russell-Edu, Barbara Vischioni, Dikran Mardighian, Lorenzo Preda, Sara Gandini, Giulia Marvaso, Matteo Augugliaro, Stefano Durante, Simona Arculeo, Filippo Patti, Dario Boccuzzi, Alessia Casbarra, Anna Starzynska, Riccardo Santoni, Barbara Alicja Jereczek-Fossa

Research output: Contribution to journalReview articlepeer-review

Abstract

AIM: To provide a literature review on risk factors and strategies to prevent acute carotid blowout (CBO) syndrome in patients who underwent reirradiation (reRT) for recurrent head and neck (HN) malignancies.

PATIENTS AND METHODS: Inclusion criteria were: 1) CBO following reRT in the HN region, 2) description on patient-, tumor- or treatment-related risk factors, 3) clinical or radiological signs of threatened or impending CBO, and 4) CBO prevention strategies.

RESULTS: Thirty-five studies were selected for the analysis from five hundred seventy-seven records. Results provided indications on clinical, radiological and dosimetric parameters possibly associated with higher risk of CBO. Endovascular procedures (artery occlusion and stenting) to prevent acute massive hemorrhage in high risk patients were discussed.

CONCLUSION: Literature data are still scarce with a low level of evidence. Nevertheless, the present work provides a comprehensive review useful for clinicians as a multidisciplinary pragmatic tool in their clinical practice.

Original languageEnglish
Pages (from-to)103088
JournalCritical Reviews in Oncology/Hematology
Volume155
DOIs
Publication statusPublished - Nov 2020

Keywords

  • Carotid Artery Diseases/etiology
  • Endovascular Procedures
  • Head and Neck Neoplasms/complications
  • Humans
  • Re-Irradiation/adverse effects
  • Retrospective Studies
  • Stents

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