鼻咽癌患者放疗后颈动脉破裂综合征：一项病例对照研究。
Postirradiated carotid blowout syndrome in patients with nasopharyngeal carcinoma: a case-control study.
作者信息
Chen Kun-Chih, Yen Ting-Ting, Hsieh Yi-Ling, Chen Hung-Chieh, Jiang Rong-San, Chen Wen-Hsien, Liang Kai-Li
机构信息
Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
出版信息
Head Neck. 2015 Jun;37(6):794-9. doi: 10.1002/hed.23671. Epub 2014 Jun 19.
BACKGROUND
Carotid blowout syndrome is one of the most devastating complications of nasopharyngeal carcinoma (NPC) therapy.
METHODS
A 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.
RESULTS
When 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.
CONCLUSION
Reirradiation 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.
背景
颈动脉破裂综合征是鼻咽癌（NPC）治疗中最具毁灭性的并发症之一。
方法
对2004年1月至2013年4月进行回顾性研究。纳入31例颈动脉破裂综合征患者，并进行病例对照研究以分析危险因素。
结果
将颈动脉破裂综合征组与匹配的无出血组进行比较时，颈动脉破裂综合征组的局部复发率和颅底放射性骨坏死（ORN）患病率显著高于对照组（均p <.001）。使用Cox比例风险模型，有或无再照射的患者之间颈动脉破裂综合征的风险比为3.599（95%置信区间，1.465 - 8.839；p =.005，经鼻咽癌切除术和化疗调整）。
结论
再照射和颅底ORN是颈动脉破裂综合征的强烈诱发因素，因此在治疗前的知情同意书中应提及。
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