Fatal carotid blowout syndrome after BNCT for head and neck cancers. (December 2015)

• Record Type: Journal Article
• Authors: Aihara, T.; Hiratsuka, J.; Ishikawa, H.; Kumada, H.; Ohnishi, K.; Kamitani, N.; Suzuki, M.; Sakurai, H.; Harada, T.
• Is Part Of: Applied radiation and isotopes. Volume 106(2015:Dec.)
• Page Start: 202
• Page End: 206
• Publication Date: 2015-12
• Subjects: Carotid blowout syndrome -- Head and neck cancer -- BNCT -- Widespread skin invasion -- Recurrence after irradiation; Radiology -- Periodicals; Radiation -- Industrial applications -- Periodicals; Nuclear chemistry -- Periodicals; Internet resource; Periodical; 660.298
• DOI: 10.1016/j.apradiso.2015.08.007
• Languages: English
• ISSNs: 0969-8043

Abstract

Abstract: Boron neutron capture therapy (BNCT) is high linear energy transfer (LET) radiation and tumor-selective radiation that does not cause serious damage to the surrounding normal tissues. BNCT might be effective and safe in patients with inoperable, locally advanced head and neck cancers, even those that recur at previously irradiated sites. However, carotid blowout syndrome (CBS) is a lethal complication resulting from malignant invasion of the carotid artery (CA); thus, the risk of CBS should be carefully assessed in patients with risk factors for CBS after BNCT. Thirty-three patients in our institution who underwent BNCT were analyzed. Two patients developed CBS and experienced widespread skin invasion and recurrence close to the carotid artery after irradiation. 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 from recurrent lesions after irradiation is an ominous sign of CBS onset and lethal consequences. Highlights: This study is fatal carotid blowout syndrome after BNCT for head and neck cancers. Thirty-three patients in our institution who underwent BNCT were analyzed. Two patients (2/33) developed CBS. The presence of skin invasion from recurrent lesions after irradiation is an ominous sign of CBS. We must be aware of these signs to perform BNCT safely.