Chemoradiation and local recurrence of head and neck squamous cell carcinoma and the risk of carotid artery blowout

Background Carotid blowout syndrome (CBS) is a rare but life‐threatening complication of head and neck squamous cell carcinoma (HNSCC). Chemoradiation (CRT) may make CBS more likely, but so far no longitudinal analysis of different treatment strategies has been conducted. Methods In the present study, 1072 patients with HNSCC were divided into groups depending on whether they had experienced CBS. Disease‐related data were analyzed using chi‐square test, Fisher exact test, and Student's t test. Survival rates were calculated using Kaplan‐Meier test, log‐rank test, and the Cox regression analysis for forward selection. Results Thirty‐six patients suffering from CBS demonstrated significantly advanced T status (P = .001) and UICC stage (P = .004) when compared with unaltered counterparts. After adjustment for UICC stage, OS was comparable in both groups, whereas the mean recurrence‐free survival (RFS) rate was better in unaltered patients (67 vs 24 months; P