Do palliative embolization in unresectable, unsalvageable recurrent and metastatic head and neck cancer patients help?

Shetty, Nitin; Menon, Nandini; Thiagarajan, Shivakumar; Sawhney, Shikar; Kulkarni, Suyash; Chaukar, Devendra A

doi:10.1007/s00405-020-06505-7

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Overall, palliative embolization was effective with a bleed-free interval from several weeks to 21 months. This report also mentions that several patients initiated palliative chemotherapy following successful embolization, but no other details were given [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Transarterial Embolization-Assisted Necrosis of a Facial Tumor

Dietz¹,

Jain²,

Monnett³

et al. 2022

Cureus

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The treatment and prognosis of non-operable high-risk head and neck squamous cell carcinoma (SCC) are poor. There is no definitive model for therapy in these cases to date, but strategies that have been utilized include radiation therapy (RT) with or without chemotherapy. Here, we report the effectiveness of arterial embolization with subsequent chemoradiation with cisplatin in a case of advanced oropharyngeal SCC. These interventions resulted in a remarkable tumor burden reduction of a stage IV SCC of the head and neck that had been deemed nonresectable.

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Section: Discussionmentioning

confidence: 99%

Transarterial Embolization-Assisted Necrosis of a Facial Tumor

Dietz¹,

Jain²,

Monnett³

et al. 2022

Cureus

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“…In a retrospective review, Shetty et al show that intra-arterial salvage embolization in patients with unresectable tumors is safe and provides adequate control of bleeding with only 3/26 (11.5%) having recurrent bleeding post-procedure. 6 Others have demonstrated the use of endovascular embolization in palliative patients with high success rates and the ability of patients to remain home with loved ones prior to this death. 7 More recently, tumor chemoembolization has grown in popularity with advances in intra-arterial catheters for superselective delivery.…”

mentioning

confidence: 99%

E-240 Endovascular thrombectomy beyond 24 hours of last known well: a systematic review and meta-analysis

Rodríguez-Calienes

Galecio‐Castillo

Vivanco-Suarez

et al. 2023

SNIS 20th Annual Meeting Electronic Poster Abstracts

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the utility and current indications for intra-arterial embolization in the management of these complex patients. Methods A comprehensive literature review was performed using PubMed on intra-arterial embolization in head and neck cancer. Discussion Intra-arterial embolization is primarily utilized in two methods in head and neck cancer: treatment of hypervascular tumors and chemoembolization of advanced cancers. The most common and well-established use of intra-arterial embolization is for head and neck paragangliomas. These are hypervascular tumors that have long been treated pre-operatively with embolization to decrease the morbidity and mortality of surgery with a well-established safety profile. Since the Society of NeuroInterventional Surgery 2012 Head, neck, and brain tumor embolization guidelines 1 this has been a pivotal aspect of these patients' treatment plan and has been repeatedly shown to have technical success rates of 90+% with minimal complications. [2][3][4] Advances in arterial embolization continue with utilization of newer agents, including success with direct injection of Squid liquid embolic agent. 5 Embolization is also commonly used as a salvage therapy to control bleeding in patients with advanced or recurrent head and neck cancer. In a retrospective review, Shetty et al show that intra-arterial salvage embolization in patients with unresectable tumors is safe and provides adequate control of bleeding with only 3/26 (11.5%) having recurrent bleeding post-procedure. 6 Others have demonstrated the use of endovascular embolization in palliative patients with high success rates and the ability of patients to remain home with loved ones prior to this death. 7 More recently, tumor chemoembolization has grown in popularity with advances in intra-arterial catheters for superselective delivery. Attempts have been made over the years to utilize this technique in advanced head and neck cancers, including attempts to use carboplatin microcapsules, 8 cisplatin crystals, 9 and more recently with drug-eluting embolic agents. 10 11 Drug-eluting embolic agents mark the next step in the progression of intra-arterial treatment of head and neck tumors and provide a promising new subset of patients. Studies have shown objective response rates in recurrent and advanced head and neck cancers from 25-60% and disease control rates of 69-100% with minimal adverse effects, showing superior efficacy and a more favorable safety profile compared to conventional chemoembolization. Conclusions Intra-arterial embolization of head and neck cancers is safe and efficacious to treat both hypervascular tumors and for chemoembolization of complicated advanced cancers.

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E-239 Role of embolization in head and neck cancer: review of indications and current practice

Capone

Patel

2023

SNIS 20th Annual Meeting Electronic Poster Abstracts

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Conclusions These findings support the theory that giant fusiform aneurysms function as a windkessel reservoir, chronically reducing distal pulse pressure which predisposes the brain vasculature to experience NPPG and potentially disastrous hemorrhage. This report is the first in the literature, to our knowledge, to identify the windkessel phenomenon and subsequent NPPB in vivo in the context of treating giant aneurysms with flow diversion. Despite an unfavorable outcome, understanding these mechanisms and employing careful intra-operative blood pressure management could mitigate or avert complications.

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Do palliative embolization in unresectable, unsalvageable recurrent and metastatic head and neck cancer patients help?

Cited by 3 publications

References 9 publications

Transarterial Embolization-Assisted Necrosis of a Facial Tumor

Transarterial Embolization-Assisted Necrosis of a Facial Tumor

E-240 Endovascular thrombectomy beyond 24 hours of last known well: a systematic review and meta-analysis

E-239 Role of embolization in head and neck cancer: review of indications and current practice

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