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Case report
Feasibility and effectiveness of palliative intensity-modulated radiotherapy for carotid sinus syndrome secondary to recurrent head and neck cancer
  1. Kentaro Wada1,
  2. Takero Hirata1,
  3. Yuichiro Shinoda2 and
  4. Teruki Teshima1
  1. 1Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
  2. 2Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
  1. Correspondence to Dr Kentaro Wada; kw10181309{at}


A 74-year-old man presented with recurrent syncope 3 months after definitive surgery for hypopharyngeal cancer. The patient experienced dizziness and severe hypotension on the movement of the neck and head. CT revealed disease recurrence with masses encasing the left internal carotid artery. The patient was diagnosed with vasodepressor type of tumour-induced carotid sinus syndrome (tiCSS) and was referred for palliative intensity-modulated radiotherapy (IMRT). Ten days after the commencement of IMRT (25 Gy in five fractions), the symptoms of tiCSS improved, and there was no re-exacerbation of the symptoms till the patient died 56 days after the commencement of RT. Palliative IMRT was feasible and effective for recurrent malignant tiCSS. Given the fact that palliative IMRT is minimally invasive, this option could be widely adapted for patients with such poor general condition and prognosis.

  • head and neck cancer
  • palliative care
  • radiotherapy

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  • Contributors KW wrote the manuscript with support from TH, YS and TT.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.