title: Acute haemorrhage in patients with advanced head and neck cancer: value of endovascular therapy as palliative treatment option.
abstract: OBJECTIVE
  Acute or subacute haemorrhage is one of the most frightening complications in patients suffering from advanced head and neck cancer. Few articles report experience with superselective endovascular therapy for this purpose. Is endovascular therapy underestimated in the field of palliative head and neck cancer therapy? This study set out to investigate this question.
  
  
  METHODS
  A review was undertaken of the clinical courses of seven patients (six men, one woman) suffering from incurable, advanced head and neck cancer (four pharyngeal, two laryngeal, one neck) and treated with superselective endovascular strategies as an emergency procedure for acute bleeding.
  
  
  RESULTS
  All patients were successfully treated without evidence of neurological complication. Patients reached a median survival of 20 weeks (range eight-168 weeks). Following endovascular treatment all patients were discharged from the hospital within several days. Three patients survived almost free of symptoms for several weeks and were able to stay at home with their families until their death.
  
  
  CONCLUSIONS
  We conclude that in the field of palliative care, superselective endovascular therapy deserves to be considered alongside standard treatment options for the management of acute haemorrhage from advanced head and neck cancer.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Philipps University, Marburg, Germany. sesterhenn@hno-marburg.de
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Sesterhenn
authors.forename: Joanna
authors.initials: J
authors.lastname: Iwinska-Zelder
authors.forename: Carsten V
authors.initials: CV
authors.lastname: Dalchow
authors.forename: Siegfried
authors.initials: S
authors.lastname: Bien
authors.forename: Jochen A
authors.initials: JA
authors.lastname: Werner
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy; D002342:Carotid Artery, External; D004621:Embolization, Therapeutic / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D051642:Histiocytoma / Q000150:complications / Q000628:therapy; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000150:complications / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000628:therapy; D010166:Palliative Care / Q000379:methods*; D016896:Treatment Outcome