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

医学 颈内动脉 鼻咽癌 列线图 比例危险模型 回顾性队列研究 闭塞 磁共振成像 外科 放射科 坏死 内科学 放射治疗
作者
Yong‐Long Liu,Kai Wen,Weijing Zhang,Yan‐Feng Ouyang,Jin‐Hua Chen,Yang‐Kui Gu,Qi Mei,Ming‐Yuan Chen,Yi‐Jun Hua,Jian Li
出处
期刊:Otolaryngology-Head and Neck Surgery [Wiley]
卷期号:170 (2): 447-456
标识
DOI:10.1002/ohn.615
摘要

Abstract 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 < .001). Surgical repair on necrosis significantly prevented hemorrhage and improved survival. The nomogram, incorporating the above 2 factors and the nearest distance from necrosis to ICA ≤ 3 mm, exhibited excellent discriminative ability for hemorrhage. We identified 3 high‐risk factors that indicate the need for prophylactic ICA management in PRNN patients: (1) exposure of ICA by rhinoscopy; (2) signs of ICA erosion on MRA scanning; (3) the depth of soft tissue coverage surrounding the ICA wall within the necrotic cavity is less than 3 mm on magnetic resonance imaging. Conclusion We have identified 3 high‐risk factors for PRNN patients that necessitate prophylactic ICA management. These findings are expected to contribute to improving the quality of life and overall survival of PRNN patients.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
JL完成签到,获得积分10
刚刚
zjw1997发布了新的文献求助30
刚刚
Lucas应助SUnnnnn采纳,获得10
1秒前
2秒前
胖心怡完成签到,获得积分10
3秒前
4秒前
goenkrrj完成签到,获得积分10
4秒前
4秒前
chun发布了新的文献求助10
4秒前
zyl发布了新的文献求助10
5秒前
5秒前
5秒前
吕创坤完成签到,获得积分10
6秒前
tt发布了新的文献求助10
7秒前
wh完成签到,获得积分10
7秒前
7秒前
goenkrrj发布了新的文献求助10
7秒前
keyaner发布了新的文献求助10
8秒前
Liskiat2021完成签到,获得积分10
8秒前
YamDaamCaa应助N0V1CE采纳,获得50
8秒前
airslake完成签到,获得积分10
9秒前
怡然映之完成签到,获得积分10
10秒前
poppy发布了新的文献求助10
10秒前
ScholarZmm完成签到,获得积分10
10秒前
Liskiat2021发布了新的文献求助10
11秒前
斯文败类应助zyl采纳,获得10
13秒前
SUnnnnn完成签到,获得积分20
15秒前
tt完成签到,获得积分10
15秒前
17秒前
半夏完成签到,获得积分10
18秒前
18秒前
Methylation完成签到,获得积分10
19秒前
19秒前
归尘应助DD采纳,获得10
20秒前
威武的匕完成签到,获得积分10
21秒前
好好学习完成签到,获得积分10
23秒前
chun完成签到,获得积分20
23秒前
研友_VZG7GZ应助奋斗藏花采纳,获得10
24秒前
25秒前
科研人发布了新的文献求助10
26秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3969917
求助须知:如何正确求助?哪些是违规求助? 3514626
关于积分的说明 11175060
捐赠科研通 3249928
什么是DOI,文献DOI怎么找? 1795165
邀请新用户注册赠送积分活动 875617
科研通“疑难数据库(出版商)”最低求助积分说明 804891