Assessment of Prophylactic Internal Carotid Artery Management in Postradiation Nasopharyngeal Necrosis Patients

Objective Postradiation nasopharyngeal necrosis (PRNN) frequently develops after second‐course radiotherapy for nasopharyngeal carcinoma (NPC). PRNN can lead to internal carotid artery (ICA) massive hemorrhage due to ICA rupture, resulting in sudden death. This study aims to explore the pretreatment...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2024-02, Vol.170 (2), p.447-456
Main Authors: Liu, Yong‐Long, Wen, Kai, Zhang, Wei‐Jing, Ouyang, Yan‐Feng, Chen, Jin‐Hua, Gu, Yang‐Kui, Mei, Qi, Chen, Ming‐Yuan, Hua, Yi‐Jun, Li, Jian
Format: Article
Language:English
Subjects:
hemorrhage
internal carotid artery
nasopharyngeal carcinoma
necrosis
radiation
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Summary:Objective Postradiation nasopharyngeal necrosis (PRNN) frequently develops after second‐course radiotherapy for nasopharyngeal carcinoma (NPC). PRNN can lead to internal carotid artery (ICA) massive hemorrhage due to ICA rupture, resulting in sudden death. This study aims to explore the pretreatment of the ICA to prevent fatal massive hemorrhage in PRNN patients. Study Design Retrospective cohort study. Setting Sun Yat‐sen University Cancer Center. Methods Patients diagnosed with NPC and PRNN from January 2010 to September 2022 were included. The Cox proportional hazards regression analysis was performed to analyze risk factors for massive hemorrhage and survival. A nomogram was developed to integrate prognostic models and perform parameter calibration. Results Two hundred and fifty‐four PRNN patients were included in this study. Prophylactic ICA occlusion significantly reduced the risk of ICA hemorrhage compared to no prophylactic ICA occlusion (3.6% vs 40.6%, P 
ISSN:0194-5998
1097-6817
DOI:10.1002/ohn.615