The impact of trans-arterial embolization on the result of chemoradiotherapy in oral cavity cancer

Abstract

Objectives: Evaluation of the hemostatic effect of trans-arterial embolization on patients with advanced oral cavity cancer who had bleeding complications while undergoing definitive concurrent chemoradiotherapy (CCRT). Additionally, assess the effect of trans-arterial embolization on treatment response following concurrent chemoradiotherapy, as well as overall survival (OS) and progression-free survival (PFS) in the group of patients following the intervention. Method: From September 2018–June 2021, a retrospective descriptive study was conducted on 16 patients with inoperable, locally advanced oral cavity cancer who received definitive concurrent chemoradiotherapy, experienced acute bleeding complications, and received selective intravascular intervention with various embolization materials at Vietnam National Cancer Hospital. Results: After selective embolization, 16/16 patients ceased bleeding; 1 patient re-bled for the second time after 3 weeks. The average duration of chemoradiotherapy interruption due to intervention was 6.7 days. After CCRT, 15/16 (93.75%) patients achieved a response, with 9/16 (56.25%) patients achieving a complete response. The median OS was 14 months (range, 3–26 months), and the median PFS was 10 months (range, 3–20 months). There were no significant complications, particularly neurological side effects. ConclusionsTumor bleeding is a common and serious complication of CCRT treatment in patients with locally advanced oral cavity cancer. Embolization is a safe and effective method of controlling acute bleeding that has no adverse effect on the outcome of definitive concurrent chemoradiotherapy.

Preoperative endovascular arterial embolization to avoid maxillary artery injury in maxillary gingival cancer surgery

“…When embolization is performed to stop bleeding in end-stage oral cancer, the embolization duration, resumption of circulation, and formation of peripheral collateral vessels are risk factors for rebleeding [ 1 ]. In our cases, embolization was performed the day before surgery, and its effect was considered minimal.…”

“…Bleeding control is crucial for safe and smooth surgery. Endovascular arterial embolization in the maxillofacial region is reportedly useful for stopping bleeding in end-stage oral cancer, multiple facial fractures, and sclerotherapy for hemangiomas [ [1] , [2] , [3] , [4] , [5] , [6] ].…”

A Case of a Dentigerous Cyst in the Maxillary Sinus Treated Preoperatively With Vascular Embolization to Avoid Intraoperative Abnormal Bleeding

“…However, it is extremely difficult to stop massive intraoperative bleeding in emergencies, and an approach to the external carotid artery may be required to stop hemorrhage occurring from the posterior wall of the maxillary sinus, where the operative field is narrow. Endovascular arterial embolization in the maxillofacial region has been reported to be useful for hemostasis in end-stage oral cancer, multiple facial fractures, and sclerotherapy of hemangiomas [1][2][3][4][5][6]. However, there have been no reports of preoperative vascular embolization being performed to prevent hemorrhage when removing a cyst that is in contact with the posterior wall of the maxillary sinus.…”