Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan.
Laryngoscope. 2021 Nov;131(11):E2777-E2783. doi: 10.1002/lary.29611. Epub 2021 May 7.
OBJECTIVES/HYPOTHESIS: The present study aimed to investigate the efficacy of transarterial embolization (TAE) for bleeding in patients with head and neck cancer (HNC) and to evaluate the prognostic factors after TAE.
Outcome study.
This retrospective study included 31 consecutive patients (27 men and 4 women; median age, 61 years) who presented uncontrollable hemorrhage associated with HNC and underwent emergency TAE at our institution during a 10-year period (January 2011-December 2020). This corresponded to 40 TAE procedures, including 27 cases with an unstable status (circulatory and/or respiratory insufficiency) and 10 cases with carotid blowout syndrome. The technical success rate and adverse events were analyzed on a per-procedure basis. The rebleeding and overall survival (OS) rates were analyzed on a per-patient basis, and the factors related to OS were evaluated.
The technical success rate was 100%. As an adverse event, cerebral infarction was found in three cases with carotid blowout syndrome. The rebleeding rate at 30 days after TAE and in the follow-up period (range, 9-3,004 days) was 17.2% and 35.5%, respectively. The median survival time was 263 days (95% confidence interval: 124.0-402.0 days). In the log-rank test, complete remission (CR) of the primary cancer at the time of the first TAE was identified as a significant influencing factor of survival.
TAE is effective for the treatment of hemorrhage associated with HNC even in patients with an unstable status. Patients with CR can gain a long life span.
4 Laryngoscope, 131:E2777-E2783, 2021.
目的/假设：本研究旨在探讨经动脉栓塞（TAE）治疗头颈部癌症（HNC）出血的疗效，并评估 TAE 后的预后因素。
回顾性研究。
本回顾性研究纳入了 31 例连续患者（27 名男性和 4 名女性；中位年龄 61 岁），这些患者因 HNC 出现无法控制的出血，并在我院进行了 10 年期间（2011 年 1 月至 2020 年 12 月）的紧急 TAE。这对应于 40 例 TAE 手术，包括 27 例不稳定状态（循环和/或呼吸功能不全）和 10 例颈动脉破裂综合征。分析了每例手术的技术成功率和不良事件。对每位患者的再出血和总生存率（OS）进行了分析，并评估了与 OS 相关的因素。
技术成功率为 100%。在颈动脉破裂综合征的 3 例患者中发现了作为不良事件的脑梗死。TAE 后 30 天和随访期间（范围 9-3004 天）的再出血率分别为 17.2%和 35.5%。中位生存时间为 263 天（95%置信区间：124.0-402.0 天）。在对数秩检验中，首次 TAE 时原发性癌症的完全缓解（CR）被确定为生存的显著影响因素。
即使在不稳定状态的患者中，TAE 对治疗与 HNC 相关的出血也是有效的。CR 的患者可以获得更长的生存期。
4 Laryngoscope, 131:E2777-E2783, 2021.
