Related factors and clinical management of epistaxis in patients irradiated for nasopharyngeal carcinoma / 中国肿瘤临床

ABSTRACT

Objective:To explore the clinical measurements for preventing and curing epistaxis in patients irradiated for nasopharyngeal carcinoma by analyzing the related factors. Methods:Thirty patients irradiated for nasopharyngeal carcinoma and consequently presented epistaxis were retrospectively reviewed by analyzing the clinical characteristics and measurements. Literature review was also performed. Results:Twenty-two cases were successfully rescued, and eight cases died (mortality rate26.6%). Twenty-five cases underwent inflation sponge packing hemostasis, whereas three cases underwent endoscopic hemostasis with cauterization. Five patients underwent digital subtraction angiography (DSA) and selective arterial embolization. For patients who underwent one irradiation course, the epistaxis latent period ranged from 3 to 12 years, and the amount of bleeding ranged from 200 mL to 1 200 mL. For patients who underwent more than one irradiation course, the epistaxis latent period ranged from 6 months to 3 years, and the amount of bleeding ranged from 300 mL to 8 000 mL. Conclusion:Packing through choanal atresia by using inflation sponge, cautery under endoscopy, DSA, and selective arterial embolization are useful and effective measurements for hemostasis. The epistaxis latent period and volume are related to the age, tumor stage, and ir-radiation course of the patients. Patients with advanced age, tumor stage, and more than one irradiation course have short latent period and high amount of bleeding.