Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Crit Rev Oncol Hematol. 2020 Nov;155:103088. doi: 10.1016/j.critrevonc.2020.103088. Epub 2020 Aug 25.
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.
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.
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.
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.
对接受复发性头颈部（HN）恶性肿瘤再放疗（reRT）的患者发生急性颈动脉破裂（CBO）综合征的危险因素和预防策略进行文献回顾。
纳入标准为：1）HN 区 reRT 后发生 CBO，2）有关于患者、肿瘤或治疗相关危险因素的描述，3）有 CBO 受威胁或即将发生的临床或影像学征象，以及 4）CBO 预防策略。
从 577 份记录中选择了 35 项研究进行分析。结果提供了与 CBO 风险较高可能相关的临床、影像学和剂量学参数的提示。讨论了对高危患者进行血管内手术（动脉闭塞和支架置入）以预防急性大出血的方法。
文献数据仍然较少，证据水平较低。然而，目前的工作提供了一个全面的综述，对临床医生来说是一个有用的多学科实用工具，可用于他们的临床实践。
