Feasibility and safety of intracranial carotid implantation with covered stents for advanced head and neck squamous cell carcinoma involving the carotid artery: A preliminary investigation.

Q2 Medicine

World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2024-03-31 eCollection Date: 2025-03-01 DOI:10.1002/wjo2.174

Hai-Dong Zhang, Kai Sun, Shan-Chun Gong, Kai Liu, Xian-Jun Lyu, Zhen-Kun Yu

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Abstract

Objective: The aim of this study was to assess the feasibility and safety of implanting covered stents in cases of advanced head and neck squamous cell carcinoma (ASCCHN) where the carotid artery was involved.

Methods: A total of 30 patients (29 males and one female) were included in this study, with ages ranging from 40 to 79 years. Among these patients, 28 patients had received radiotherapy and 17 received subsequent adjuvant therapy, while one was receiving treatment for the first time. Eighteen were treated with covered stent implantation in conjunction with surgery, and the remaining 12 received stent implantation alone. The study evaluated and compared the stent implantation's success rate, overall survival (OS), and associated complications.

Results: Successful implantation of covered stents was achieved in all 30 cases. No instances of significant hemorrhage or thromboembolic cerebral infarction occurred during surgery. Of the patients in the salvage surgical group, 15 underwent complete tumor resection with a success rate of 83.3% (15/18), of which four experienced tumor recurrence with a local recurrence rate of 26.7% (4/15). The OS rates at 6 months for all patients, the salvage surgical group, the 15 patients with complete tumor resection, and the nonsurgical group were 64.0%, 66.8%, 75.5%, and 58.6%, respectively. At 12 months, the OS rates were 21.4%, 29.3%, 43.2%, and 11.8%, respectively. Notably, the OS of the 15 patients who underwent complete tumor resection was significantly higher than that of the 12 patients who received stent implantation alone (p = 0.044). All cerebrovascular accidents occurred in patients with radiotherapy history, and subsequent adjuvant therapy had no significant effect on the OS time in the salvage surgical and nonsurgical groups (p = 0.935; p = 0.526).

Conclusion: In cases of ASCCHN involving the carotid artery, the implantation of covered stents is a safe and feasible procedure.

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覆盖支架颅内颈动脉植入术治疗累及颈动脉的晚期头颈部鳞状细胞癌的可行性和安全性：初步研究。

目的：本研究的目的是评估在累及颈动脉的晚期头颈部鳞状细胞癌（ASCCHN）中植入覆盖支架的可行性和安全性。方法：共纳入30例患者，其中男29例，女1例，年龄40 ~ 79岁。其中放疗28例，后续辅助治疗17例，首次治疗1例。其中18例手术联合支架植入术，其余12例单独支架植入术。该研究评估并比较了支架植入的成功率、总生存期（OS）和相关并发症。结果：30例患者均成功植入有盖支架。手术期间未发生明显出血或血栓栓塞性脑梗死。抢救手术组15例患者全部切除肿瘤，成功率83.3%(15/18)，其中4例肿瘤复发，局部复发率26.7%（4/15）。6个月时，所有患者、抢救手术组、15例肿瘤完全切除组和非手术组的总生存率分别为64.0%、66.8%、75.5%和58.6%。12个月时，总生存率分别为21.4%、29.3%、43.2%和11.8%。值得注意的是，15例完全切除肿瘤患者的OS明显高于单纯支架植入术的12例患者（p = 0.044）。所有脑血管意外均发生在有放疗史的患者中，术后辅助治疗对补救性手术组和非手术组的OS时间无显著影响(p = 0.935；p = 0.526)。结论：对于累及颈动脉的ASCCHN，覆盖支架植入术是一种安全可行的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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