Department of Otolaryngology Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Australia.
Neurological Intervention and Imaging Service of Western Australia ('NIISwa'), Sir Charles Gairdner Hospital, Perth, Australia.
J Laryngol Otol. 2023 Jun;137(6):667-672. doi: 10.1017/S0022215122001918. Epub 2022 Aug 18.
Major haemorrhage is a rare complication after chemoradiotherapy for oropharyngeal squamous cell carcinoma. This is managed by interventional neuroradiology with endovascular embolisation of the bleeding vessel. This study aimed to describe radiological and clinical predictors of haemorrhage.
A retrospective case series was conducted of all patients with oropharyngeal squamous cell carcinomas who suffered a major haemorrhage requiring embolisation during or after treatment with chemoradiotherapy or radiotherapy alone, between 2013 and 2021, in Western Australia.
This study included 14 patients, in two groups: haemorrhage group ( = 70) and tumour stage matched non-haemorrhage group ( = 7). Patients who haemorrhaged had a larger average transverse axial tumour size on pre-treatment computed tomography (38 mm 22 mm; = 0.02) and tumours tended to involve the proximal aspect of the offending bleeding vessel. All patients who haemorrhaged developed deep cavitating or ulcerative tumour bed changes on post-treatment imaging ( < 0.0001).
Tumour bed ulceration or cavitation appears to be highly predictive of haemorrhage in this patient cohort.
头颈部鳞状细胞癌放化疗后发生大出血较为罕见，可通过介入神经放射学进行血管内栓塞治疗。本研究旨在描述出血的放射学和临床预测因素。
对 2013 年至 2021 年期间，西澳大利亚因头颈部鳞状细胞癌放化疗或单纯放疗后发生大出血而需进行血管内栓塞治疗的患者进行回顾性病例系列研究，纳入标准为大出血需行栓塞治疗。
本研究纳入 14 例患者，分为出血组（70 例）和肿瘤分期匹配的非出血组（7 例）。与非出血组相比，出血组患者治疗前 CT 上的肿瘤平均横径较大（38 mm ± 22 mm； = 0.02），肿瘤更倾向于累及出血血管的近端。所有出血患者的肿瘤床在治疗后均出现深腔性或溃疡性改变（ < 0.0001）。
在本患者队列中，肿瘤床溃疡或空洞似乎是出血的高度预测因素。
