Etiology and management of nasopharyngeal hemorrhage after radiotherapy for nasopharyngeal carcinoma
Year: 2019
Type: article
Study design: Observational Study
Abstract: Jiabin Zhan,1,* Shuai Zhang,2,* Xin Wei,1 Yihui Fu,3 Jing Zheng1 1Department of Otolaryngology, Hainan General Hospital, Haikou 570311, Hainan, China; 2Department of Radiation Oncology, Hainan General Hospital, Haikou 570311, Hainan Province, China; 3Department of Respiratory Medicine, Hainan General Hospital, Haikou 570311, Hainan Province, China *These authors contributed equally to this work Objective: To analyze the etiology of nasopharyngeal hemorrhage after radiotherapy for nasopharyngeal carcinoma (NPC) and evaluate the relevant management and rescue approaches. Methods: Seventeen cases of nasopharyngeal hemorrhage caused by radiotherapy of NPC, treated between January 2015 and March 2018, were retrospectively analyzed to study the etiology of nasopharyngeal hemorrhage. The management and rescue strategies, including anterior and posterior nostril packing, endoscopic nasopharynx electrocoagulation, and digital subtraction angiography embolization, were assessed for their effectiveness. Results: Nasopharynx hemorrhage after radiotherapy of NPC was mainly associated with erosion of the internal carotid artery or maxillary artery by the tumor. Among the 17 cases, 11 patients were treated by digital subtraction arterial angiography embolization, and 3 were treated by endoscopic nasopharynx electrocoagulation. Overall, 13 patients survived, while 4 died. Conclusion: Anterior and posterior nostril packing, endoscopic nasopharynx electrocoagulation, and digital subtraction angiography embolization are suitable for treating nasopharyngeal hemorrhage. However, effective hemostasis depends on early identification of the bleeding vessels. Keywords: nasopharyngeal carcinoma (NPC), nasopharyngeal hemorrhage, radiotherapy, prognosis
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4389007130