Characteristics and treatment of epistaxis in nasopharyngeal carcinoma.

Autor: Wu WB; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, PR China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, PR China; Nasopharyngeal Cancer Center, Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, PR China., Xia L; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, PR China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, PR China., Feng ZK; Nasopharyngeal Cancer Center, Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, PR China., Liang JL; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, PR China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, PR China., Ding X; Nasopharyngeal Cancer Center, Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, PR China., Chen SY; Nasopharyngeal Cancer Center, Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, PR China., You R; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, PR China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, PR China; Nasopharyngeal Cancer Center, Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, PR China., Chen MY; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, PR China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, PR China; Nasopharyngeal Cancer Center, Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, PR China; The First Hospital of Nanchang, Nanchang, China; Nanchang Research Institute, Sun Yat-Sen University, Nanchang 330096, China. Electronic address: chmingy@mail.sysu.edu.cn., Liu YP; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, PR China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, PR China; Nasopharyngeal Cancer Center, Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua East Road, Zhuhai, Guangdong 519000, PR China. Electronic address: liuyp78@mail.sysu.edu.cn.
Jazyk: angličtina
Zdroj: Oral oncology [Oral Oncol] 2024 Oct 17; Vol. 159, pp. 107071. Date of Electronic Publication: 2024 Oct 17.
DOI: 10.1016/j.oraloncology.2024.107071
Abstrakt: Objectives: To analyze the risk factors and explore effective treatments for epistaxis in nasopharyngeal carcinoma (NPC) patients.
Methods: From March 2006 to February 2020, 351 epistaxis patients visited our center and 195 patients meeting the inclusion criteria were enrolled in the study. Characteristics and treatments, including step-up hemostatic treatment (including medication, anterior ± posterior nostril packing, or further surgical hemostasis) and the CTPI emergency hemostasis method (including common carotid artery compression, tracheotomy / intubation, packing of nasal and nasopharynx, and interventional treatment), were analyzed.
Results: The median total bleeding volume was 100.0 ml (range 20-4430 ml). 126 (64.6 %) and 69 (35.4 %) patients suffered from non-massive epistaxis and massive epistaxis. The 1-year overall survival (OS) rate was 60.1 % for patients with massive epistaxis and 97.3 % for those with non-massive epistaxis treated with step-up hemostatic treatment. Among patients with massive epistaxis, the 1-year OS rate was 80.0 % for those who received CTPI and 13.3 % for those who received step-up hemostatic treatment.
Conclusion: ICA exposure and hemostasis failure was adverse prognostic factors for OS in NPC patients with epistaxis. The step-up hemostatic treatment is effective for controlling non-massive epistaxis. The CTPI emergency method might be an effective hemostasis treatment for NPC patients with massive epistaxis, especially those with PRNN and ICA exposure.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: