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Acute haemorrhage in patients with advanced head and neck cancer: value of endovascular therapy as palliative treatment option

Published online by Cambridge University Press:  14 December 2005

Andreas M Sesterhenn ,
Joanna Iwinska-Zelder ,
Carsten V Dalchow ,
Siegfried Bien  and
Jochen A Werner
Andreas M Sesterhenn
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Philipps University, Marburg, Germany
Joanna Iwinska-Zelder
Affiliation:
Department of Neuroradiology, Philipps University, Marburg, Germany
Carsten V Dalchow
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Philipps University, Marburg, Germany
Siegfried Bien
Affiliation:
Department of Neuroradiology, Philipps University, Marburg, Germany
Jochen A Werner
Affiliation:
Department of Otolaryngology, Head & Neck Surgery, Philipps University, Marburg, Germany
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Abstract

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Aims: Acute or subacute haemorrhage is one of the most frightening complications in patients suffering from advanced head and neck cancer. Few articles report experience with superselective endovascular therapy for this purpose. Is endovascular therapy underestimated in the field of palliative head and neck cancer therapy? This study set out to investigate this question.

Patients and methods: A review was undertaken of the clinical courses of seven patients (six men, one woman) suffering from incurable, advanced head and neck cancer (four pharyngeal, two laryngeal, one neck) and treated with superselective endovascular strategies as an emergency procedure for acute bleeding.

Results: All patients were successfully treated without evidence of neurological complication. Patients reached a median survival of 20 weeks (range eight–168 weeks). Following endovascular treatment all patients were discharged from the hospital within several days. Three patients survived almost free of symptoms for several weeks and were able to stay at home with their families until their death.

Conclusion: We conclude that in the field of palliative care, superselective endovascular therapy deserves to be considered alongside standard treatment options for the management of acute haemorrhage from advanced head and neck cancer.

Keywords

Therapeutic EmbolizationHead and Neck CancerCarotid ArteryExternalHaemorrhage
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 120 , Issue 2 , February 2006 , pp. 117 - 124
Copyright
© 2005 JLO (1984) Limited