Baroreflex failure following radiation therapy for nasopharyngeal carcinoma.
The authors present a 51-year-old man with right-sided nasopharyngeal carcinoma who was treated for regional lymph node involvement by bilateral radiation therapy of the neck. Six years later he presented with episodic complaints of headache, flushing, and palpitations accompanied by elevations of blood pressure. Examination of arterial baroreflex function indicated selective afferent carotid sinus denervation. Cross spectral analysis of spontaneous heart rate and blood pressure variability showed decreased arterial baroreflex sensitivity (6.5 ms/mm Hg). Twenty-four hour measurements of blood pressure and heart rate variability showed labile hypertension during normal daytime activities. Baroreflex failure in this patient probably represents a late complication of bilateral radiation therapy of the neck.
Timmers
H J
HJ
Department of General Internal Medicine, St. Radboud University Hospital Nijmegen, The Netherlands.
Karemaker
J M
JM
Lenders
J W
JW
Wieling
W
W
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017704:Baroreflex / Q000528:radiation effects*; D001794:Blood Pressure; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005221:Fatigue; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*; D010146:Pain; D011187:Posture; D011878:Radiotherapy / Q000009:adverse effects*; D012074:Remission Induction; D014636:Valsalva Maneuver / Q000528:radiation effects; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D003520:Cyclophosphamide; D008727:Methotrexate