Karadaghy Omar A, Peterson Andrew M, Sawaf Tuleen, Renslo Bryan, Miller Brevin, Virgen Celina, Sykes Kevin J, Doering Michelle M, Moran Christopher J, Ullman Henrik, Peterson Jeremy, Pipkorn Patrik, Bur Andrés M
Department of Otolaryngology - Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA.
Department of Otolaryngology - Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, USA.
Head Neck. 2025 Jan;47(1):34-46. doi: 10.1002/hed.27875. Epub 2024 Jul 26.
The management of acute hemorrhage in patients with previously treated head and neck squamous cell carcinoma (HNSCC) is challenging due to the lack of substantial evidence to guide clinical decision making.
A systematic review and retrospective chart review were performed to identify patients with a history of HNSCC who underwent either primary or adjuvant radiation therapy (RT) and presented with hemorrhagic complications requiring embolization. Patient characteristics, history, presentation, and outcomes were reviewed.
The systematic review included a total of 182 patients. Heterogeneity existed in outcomes reporting; 1-year overall survival approached 50%. From the retrospective chart review, 51 patients were included. Median survival time following hemorrhage was 2.2 months (range 1.2-11.4 months). Patients with malignancy at time of hemorrhage were identified as having worse survival.
Acute hemorrhage in patients with a history of previously radiated HNSCC portends a high risk of mortality, with patients with active malignancy representing a worse prognostic group.
既往接受过治疗的头颈部鳞状细胞癌（HNSCC）患者的急性出血管理具有挑战性，因为缺乏指导临床决策的充分证据。
进行了一项系统评价和回顾性病历审查，以确定有HNSCC病史且接受过根治性或辅助性放射治疗（RT）并出现需要栓塞治疗的出血并发症的患者。对患者的特征、病史、临床表现和结局进行了审查。
系统评价共纳入182例患者。结局报告存在异质性；1年总生存率接近50%。回顾性病历审查纳入了51例患者。出血后的中位生存时间为2.2个月（范围1.2 - 11.4个月）。出血时患有恶性肿瘤的患者生存情况较差。
既往接受过放射治疗的HNSCC患者发生急性出血预示着高死亡风险，有活动性恶性肿瘤的患者预后更差。
