KẾT QUẢ CAN THIỆP NỘI MẠCH ĐIỀU TRỊ BIẾN CHỨNG CHẢY MÁU DO UNG THƯ VÙNG ĐẦU MẶT CỔ TẠI BỆNH VIỆN ĐA KHOA TỈNH PHÚ THỌ

Abstract

Objectives: To assess the outcomes of transarterial embolization in managing hemorrhagic complications associated with head and neck cancers in a case series from Phu Tho Provincial General Hospital. Subjects and methods: A retrospective study was conducted on 21 patients with head and neck cancers who underwent transarterial embolization for hemorrhagic complications between November 2022 and November 2025. Results: A total of 21 patients were enrolled in the study, including 17 men and 4 women, with a mean age of 57.7 years. Primary tumor sites consisted of the tongue (8 patients; 38.1%), oral cavity (2; 9.5%), hypopharynx (2; 9.5%), tonsil (2; 9.5%), and other head-and-neck subsites (7; 33.3%). The majority of patients (17/21; 80.9%) presented with T4-stage disease, and the mean duration of illness prior to admission was 15.8 months. At presentation, 17 patients (80.9%) had been undergoing chemotherapy and/or radiotherapy, and 6 (28.6%) were in hypovolemic shock. Active hemorrhage on CT angiography was identified in 7 patients (33.3%)( including 2 cases of direct external carotid artery bleeding), and 5 cases (23.8%) presented pseudoaneurysm. Hypervascular enhancement on CT was observed in 9 patients (42.9%). Endovascular intervention achieved a technical success rate of 95.2% (20/21) and a clinical success rate of 90.5% (19/21). Embolic agents included gelatin sponge (8 patients; 38.1%) and coils (6; 28.6%). One patient experienced unilateral facial edema as a complication resulting from complete occlusion of the external carotid artery. During follow-up, 17 patients died. One patient (5.9%) died due to technical failure, while 16 patients died later in the course of follow-up, with a median survival of 11 weeks (range, 1–63 weeks). Causes of death included advanced tumor progression in 13 patients (76.5%) and recurrent hemorrhage in 3 patients (17.6%). Conclusion: Endovascular intervention is highly effective for controlling hemorrhagic complications in patients with head and neck cancers, demonstrating a high technical and clinical success rate. Nevertheless, overall survival remains limited, primarily due to the advanced or end-stage disease status in most patients.