Key points:
- This article is the first one to study the survival rate of different
degrees of carotid artery invaded by nasopharyngeal carcinoma.
- The incidence of fatal bleeding after radiotherapy was only 2.3%
(3/130).
- The circumference of tumor attachment to the artery and the
disappearance of fat gaps were utilized to estimate the extent of
carotid artery invasion , which was classified into three subtypes
according to the involvement grade before therapy.
- In LANC patients whose carotid artery invasion was <270º,
helical tomotherapy combined with concurrent chemotherapy and EGFR
inhibitor after induction chemotherapy had mild and tolerable side
effects, better PFS and DMFS, with no massive hemorrhage.
- In patients whose primary tumor was pharyngeal recess with carotid
artery invasion ≥270º, diabetes with poor control or re-radiotherapy
led to a higher risk of massive hemorrhage after radiotherapy.