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Etiology and management of nasopharyngeal hemorrhage after radiotherapy for nasopharyngeal carcinoma

Authors Zhan J, Zhang S, Wei X, Fu Y, Zheng J

Received 11 August 2018

Accepted for publication 31 December 2018

Published 15 March 2019 Volume 2019:11 Pages 2171—2178

DOI https://doi.org/10.2147/CMAR.S183537

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Rituraj Purohit


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

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