Department of Interventional Radiology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India.
Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, 400012, India.
Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3401-3407. doi: 10.1007/s00405-020-06505-7. Epub 2021 Jan 3.
Bleeding from the unsalvageable recurrent and metastatic head and neck cancer is not an uncommon occurrence. It is extremely distressing for the patients and their family members and also to the treating doctors. One of the ways to manage this crisis is by selective embolization of the bleeding vessel.
In this retrospective study, we audited the patients with unresectable, unsalvageable recurrent and/or metastatic head and neck cancer who underwent selective (palliative) embolization for bleeding at our institute between Jan 2015 and Nov 2019, and assessed its possible benefit in terms of bleeding free interval achieved.
Twenty-six palliative embolization was done during the above mentioned period. The majority were male patients (n = 23, 88.4%) with a median age of 54.5 years. The performance status (PS) of most patients was 2 (n = 15, 57.6%). The most common bleeding vessel was the external carotid artery or one of its branches, most commonly lingual artery (n = 5). The bleeding vessel was identified and embolized with PVA/gel foam/coil/glue. All the procedures were uneventful. Out of 26 patients, 3 patients had another bleeding episode subsequently. Most patients had 20 days to 21 months of bleeding free interval. The cost involved in the procedure was between 400 and 2100 US dollars.
Selective embolization is an option to be considered in certain patients with unresectable, unsalvageable recurrent and/or metastatic head and neck cancer, when they present with sudden and massive bleeding to the emergency department, at centres where the facility and expertise for this procedure might be available.
无法挽救的复发性和转移性头颈部癌症出血并不罕见。这对患者及其家属以及治疗医生来说都是极其痛苦的。处理这种危机的方法之一是对出血血管进行选择性栓塞。
在这项回顾性研究中，我们审核了在我院于 2015 年 1 月至 2019 年 11 月期间因出血接受不可切除、无法挽救的复发性和/或转移性头颈部癌症选择性（姑息性）栓塞的患者，并评估了其在实现无出血间隔方面的可能益处。
在上述时间段内进行了 26 例姑息性栓塞。大多数患者为男性（n=23，88.4%），中位年龄为 54.5 岁。大多数患者的表现状态（PS）为 2（n=15，57.6%）。最常见的出血血管是颈外动脉或其分支，最常见的是舌动脉（n=5）。用 PVA/凝胶泡沫/线圈/胶进行栓塞。所有的手术都很顺利。在 26 例患者中，有 3 例随后出现另一次出血事件。大多数患者的无出血间隔为 20 天至 21 个月。该过程涉及的费用在 400 至 2100 美元之间。
在某些无法切除、无法挽救的复发性和/或转移性头颈部癌症患者出现紧急情况且大量出血时，在具有该手术设施和专业知识的中心，选择性栓塞是一种可以考虑的选择。
