{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:35:46Z","timestamp":1787070946304,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"\n Aims:<\/jats:title>\n The aim of the study is to investigate the clinicopathological factors that determine prognosis of nasopharyngeal hemorrhage after radiotherapy in patients with nasopharyngeal carcinoma (NPC).<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n The clinicopathological data of 539 patients with NPC, who received radiotherapy, were analyzed retrospectively. Parameters included gender; age; T-stage; N-stage; pathological type; type of radiotherapy; synchronous chemotherapy; secondary-course radiotherapy; radiation-induced skull base osteonecrosis; diabetes, hypertension, or other systemic diseases; results of nasopharyngeal bacterial culture; and nasopharyngeal tumor recurrence. Univariate and multivariate analyses were performed using the Chi-square test and logistic regression. Afterward, the Kaplan\u2013Meier's method was applied to analyze the survival of patients with nasopharyngeal hemorrhage.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among all patients examined, 64 (11.9%) had nasopharyngeal hemorrhage after radiotherapy. The univariate analysis showed that T-stage (\n P<\/jats:italic>\n < 0.01), secondary-course radiotherapy (\n P<\/jats:italic>\n < 0.01), radiation-induced skull base osteonecrosis (\n P<\/jats:italic>\n < 0.01), nasopharyngeal bacterial culture results (\n P<\/jats:italic>\n < 0.01), and nasopharyngeal tumor recurrence (\n P<\/jats:italic>\n < 0.01) were associated with nasopharyngeal hemorrhage. Multivariate analysis showed that only radiation-induced skull base osteonecrosis was significantly associated with nasopharyngeal hemorrhage after radiotherapy (odds ratio = 41.83,\n P<\/jats:italic>\n = 0.0001). Nevertheless, in patients with internal carotid artery hemorrhage, the survival rate was much lower than that in patients with external carotid artery bleeding. The main cause of death during follow-up was rebleeding.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The rate of mortality in patients with nasopharyngeal hemorrhage after radiotherapy was high. The presence of radiation-induced skull base osteonecrosis was a decisive factor in these patients. However, after successful rescue, arterial embolization or stent implantation is proposed to prolong survival.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcrt.jcrt_586_21","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T06:59:55Z","timestamp":1679900395000},"page":"1219-1224","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Clinicopathological factors affecting the prognosis of massive hemorrhage after radiotherapy for patients having nasopharyngeal 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