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38 - Interventional Neuroradiology in Head and Neck Oncology

from PART III - ORGAN-SPECIFIC CANCERS

Published online by Cambridge University Press:  18 May 2010

By
John B. Weigele  and
Robert W. Hurst
Edited by
Jean-François H. Geschwind  and
Michael C. Soulen
John B. Weigele
Affiliation:
Assistant Professor, Division of Interventional Neuroradiology University of Pennsylvania Philadelphia, PA
Robert W. Hurst
Affiliation:
Professor of Radiology, Division of Interventional Neuroradiology University of Pennsylvania Philadelphia, PA
Jean-François H. Geschwind
Affiliation:
The Johns Hopkins University School of Medicine
Michael C. Soulen
Affiliation:
University of Pennsylvania School of Medicine
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Summary

Interventional neuroradiologic procedures are integral to the management of patients with head and neck tumors. Preoperative embolization of vascular neoplasms is used at many centers to minimize intraoperative hemorrhage and facilitate surgical resection. Also, balloon test occlusion provides a valuable preoperative assessment of an artery that may undergo surgical sacrifice. In some cases, preoperative permanent arterial occlusion facilitates radical tumor resection. In addition, endovascular techniques are critically important for the control of intractable hemorrhage due to vascular erosion from tumor or complications of therapy (carotid blowout syndrome). Finally, selective intra-arterial infusion of chemotherapeutic agents contributes to the multidisciplinary management of malignant head and neck carcinomas. The role of interventional neuroradiology in head and neck oncology promises to expand as new devices and techniques are developed.

EMBOLIZATION OF VASCULAR HEAD AND NECK TUMORS

Vascular head and neck tumors frequently are referred for preoperative embolization. Most common are juvenile nasopharyngeal angiofibromas (JNAs) and paragangliomas. Various other vascular head and neck tumors also have been embolized (1–3). Preoperative embolization is widely believed to improve surgical outcomes by decreasing surgical blood loss, minimizing operative time, and facilitating the tumor resection. Nonetheless, no level I evidence exists. Many case series have been published supporting preoperative embolization; a minority of conflicting reports concludes preoperative embolization only adds risk without significantly improving surgical morbidity and mortality (4).

Technique

Two techniques have been developed for preoperative embolization of vascular head and neck tumors: transarterial embolization with small particulates and direct-puncture embolization with liquid embolic agents (1–7).

Type
Chapter
Information
Interventional Oncology
Principles and Practice
 , pp. 483 - 497
Publisher: Cambridge University Press
Print publication year: 2008

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References

Valavanis, A and Christoforidis, G. Applications of interventional neuroradiology in the head and neck. Semin Roentgenol, 2000; 35(1): 72–83.CrossRefGoogle ScholarPubMed
Chaloupka, J C, Mangla, S, Huddle, D C, et al. Evolving experience with direct puncture therapeutic embolization for adjunctive and palliative management of head and neck hypervascular neoplasms. Laryngoscope, 1999; 109(11): 1864–1872.CrossRefGoogle ScholarPubMed
Casasco, A, Houdart, E, Biondi, A, et al. Major complications of percutaneous embolization of skull-base tumors. AJNR Am J Neuroradiol, 1999; 20(1): 179–181.Google ScholarPubMed
Smith, T P. Embolization in the external carotid artery. J Vasc Interv Radiol, 2006; 17(12): 1897–1912; quiz 1913.CrossRefGoogle ScholarPubMed
Casasco, A, Herbreteau, D, Houdart, E, et al. Devascularization of craniofacial tumors by percutaneous tumor puncture. AJNR Am J Neuroradiol, 1994; 15(7): 1233–1239.Google ScholarPubMed
Abud, D G, Mounayer, C, Benndorf, G, et al. Intratumoral injection of cyanoacrylate glue in head and neck paragangliomas. AJNR Am J Neuroradiol, 2004; 25(9): 1457–1462.Google ScholarPubMed
Gobin, Y P, Murayama, Y, Milanese, K, et al. Head and neck hypervascular lesions: Embolization with ethylene vinyl alcohol copolymer – laboratory evaluation in swine and clinical evaluation in humans. Radiology, 2001; 221(2): 309–317.CrossRefGoogle ScholarPubMed
Schick, B and Kahle, G. Radiological findings in angiofibroma. Acta Radiol, 2000; 41(6): 585–593.CrossRefGoogle ScholarPubMed
Scholtz, A W, Appenroth, E, Kammen-Jolly, K, et al. Juvenile nasopharyngeal angiofibroma: Management and therapy. Laryngoscope, 2001; 111(4 Pt 1): 681–687.CrossRefGoogle ScholarPubMed
Siniluoto, T M, Luotonen, J P, Tikkakoski, T A, et al. Value of pre-operative embolization in surgery for nasopharyngeal angiofibroma. J Laryngol Otol, 1993; 107(6): 514–521.CrossRefGoogle Scholar
Mistry, R C, Qureshi, S S, and Gupta, S. Juvenile nasopharyngeal angiofibroma: A single institution study. Indian J Cancer, 2005; 42(1): 35–39.CrossRefGoogle ScholarPubMed
Moulin, G, Chagnaud, C, Gras, R, et al. Juvenile nasopharyngeal angiofibroma: Comparison of blood loss during removal in embolized group versus nonembolized group. Cardiovasc Intervent Radiol, 1995; 18(3): 158–161.CrossRefGoogle ScholarPubMed
Li, J R, Qian, J, Shan, X Z, et al. Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol, 1998; 255(8): 430–432.CrossRefGoogle Scholar
Glad, H, Vainer, B, Buchwald, C, et al. Juvenile nasopharyngeal angiofibromas in Denmark 1981–2003: Diagnosis, incidence, and treatment. Acta Otolaryngol, 2007; 127(3): 292–299.CrossRefGoogle ScholarPubMed
Costa, da D M, Franche, G L, Gessinger, R P, et al. Surgical experience with juvenile nasopharyngeal angiofibroma. Ann Otolaryngol Chir Cervicofac, 1992; 109(5): 231–234.Google ScholarPubMed
Duvall, A J 3rd and Moreano, A E. Juvenile nasopharyngeal angiofibroma: Diagnosis and treatment. Otolaryngol Head Neck Surg, 1987; 97(6): 534–540.CrossRefGoogle ScholarPubMed
Petruson, K, Rodriguez-Catarino, M, Petruson, B, et al. Juvenile nasopharyngeal angiofibroma: Long-term results in preoperative embolized and non-embolized patients. Acta Otolaryngol, 2002; 122(1): 96–100.CrossRefGoogle ScholarPubMed
Onerci, M, Gumus, K, Cil, B, et al. A rare complication of embolization in juvenile nasopharyngeal angiofibroma. Int J Pediatr Otorhinolaryngol, 2005; 69(3): 423–428.CrossRefGoogle ScholarPubMed
Horowitz, M B, Carrau, R, Crammond, D, et al. Risks of tumor embolization in the presence of an unrecognized patent foramen ovale: Case report. AJNR Am J Neuroradiol, 2002; 23(6): 982–984.Google ScholarPubMed
Berg, R. Imaging and management of head and neck paragangliomas. Eur Radiol, 2005; 15(7): 1310–1318.CrossRefGoogle ScholarPubMed
Persky, M S, Setton, A, Niimi, Y, et al. Combined endovascular and surgical treatment of head and neck paragangliomas – a team approach. Head Neck, 2002; 24(5): 423–431.CrossRefGoogle ScholarPubMed
Wang, S J, Wang, M B, Barauskas, T M, et al. Surgical management of carotid body tumors. Otolaryngol Head Neck Surg, 2000; 123(3): 202–206.CrossRefGoogle ScholarPubMed
Tikkakoski, T, Luotonen, J, Leinonen, S, et al. Preoperative embolization in the management of neck paragangliomas. Laryngoscope, 1997; 107(6): 821–826.CrossRefGoogle ScholarPubMed
Liu, D G, Ma, X C, Li, B M, et al. Clinical study of preoperative angiography and embolization of hypervascular neoplasms in the oral and maxillofacial region. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006; 101(1): 102–109.CrossRefGoogle ScholarPubMed
Kasper, G C, Welling, R E, Wladis, A R, et al. A multidisciplinary approach to carotid paragangliomas. Vasc Endovascular Surg, 2006; 40(6): 467–474.CrossRefGoogle ScholarPubMed
American Society of Interventional and Therapeutic Neuroradiology. Carotid artery balloon test occlusion. AJNR Am J Neuroradiol, 2001; 22(8 Suppl): S8–S9.
Linskey, M E, Jungreis, C A, Yonas, H, et al. Stroke risk after abrupt internal carotid artery sacrifice: accuracy of preoperative assessment with balloon test occlusion and stable xenon-enhanced CT. AJNR Am J Neuroradiol, 1994; 15(5): 829–843.Google ScholarPubMed
Serbinenko, F A. Balloon catheterization and occlusion of major cerebral vessels. J Neurosurg, 1974; 41(2): 125–145.CrossRefGoogle ScholarPubMed
Mathis, J M, Barr, J D, Jungreis, C A, et al. Temporary balloon test occlusion of the internal carotid artery: Experience in 500 cases. AJNR Am J Neuroradiol, 1995; 16(4): 749–754.Google ScholarPubMed
Meyers, P M, Thakur, G A, and Tomsick, T A. Temporary endovascular balloon occlusion of the internal carotid artery with a nondetachable silicone balloon catheter: Analysis of technique and cost. AJNR Am J Neuroradiol, 1999; 20(4): 559–564.Google ScholarPubMed
Marshall, R S, Lazar, R M, Young, W L, et al. Clinical utility of quantitative cerebral blood flow measurements during internal carotid artery test occlusions. Neurosurgery, 2002; 50(5): 996–1004; discussion, 1004–1005.Google ScholarPubMed
Rooij, W J, Sluzewski, M, Slob, M J, et al. Predictive value of angiographic testing for tolerance to therapeutic occlusion of the carotid artery. AJNR Am J Neuroradiol, 2005; 26(1): 175–178.Google ScholarPubMed
Adams, G L, Madison, M, Remley, K, et al. Preoperative permanent balloon occlusion of internal carotid artery in patients with advanced head and neck squamous cell carcinoma. Laryngoscope, 1999; 109(3): 460–466.CrossRefGoogle ScholarPubMed
Sanna, M, Piazza, P, Ditrapani, G, et al. Management of the internal carotid artery in tumors of the lateral skull base: Preoperative permanent balloon occlusion without reconstruction. Otol Neurotol, 2004; 25(6): 998–1005.CrossRefGoogle ScholarPubMed
Zane, R S, Aeschbacher, P, Moll, C, et al. Carotid occlusion without reconstruction: A safe surgical option in selected patients. Am J Otol, 1995; 16(3): 353–359.Google ScholarPubMed
Vries, E J, Sekhar, L N, Janecka, I P, et al. Elective resection of the internal carotid artery without reconstruction. Laryngoscope, 1988; 98(9): 960–966.CrossRefGoogle ScholarPubMed
Kotapka, M J, Kalia, K K, Martinez, A J, et al. Infiltration of the carotid artery by cavernous sinus meningioma. J Neurosurg, 1994; 81(2): 252–255.CrossRefGoogle ScholarPubMed
Browne, J D, Fisch, U, and Valavanis, A. Surgical therapy of glomus vagale tumors. Skull Base Surg, 1993; 3(4): 182–192.CrossRefGoogle ScholarPubMed
Vries, E J, Sekhar, L N, Horton, J A, et al. A new method to predict safe resection of the internal carotid artery. Laryngoscope, 1990; 100(1): 85–88.CrossRefGoogle ScholarPubMed
Sekhar, L N and Patel, S J. Permanent occlusion of the internal carotid artery during skull-base and vascular surgery: Is it really safe?Am J Otol, 1993; 14(5): 421–422.Google ScholarPubMed
Kallmes, D F and Cloft, H J. The use of hydrocoil for parent artery occlusion. AJNR Am J Neuroradiol, 2004; 25(8): 1409–1410.Google ScholarPubMed
Ross, I B and Buciuc, R. The vascular plug: A new device for parent artery occlusion. AJNR Am J Neuroradiol, 2007; 28(2): 385–386.Google ScholarPubMed
Nussbaum, E S, Levine, S C, Hamlar, D, et al. Carotid stenting and “extarterectomy” in the management of head and neck cancer involving the internal carotid artery: Technical case report. Neurosurgery, 2000; 47(4): 981–984.CrossRefGoogle ScholarPubMed
Sanna, M, Khrais, T, Menozi, R, et al. Surgical removal of jugular paragangliomas after stenting of the intratemporal internal carotid artery: A preliminary report. Laryngoscope, 2006; 116(5): 742–746.CrossRefGoogle ScholarPubMed
Tripp, H F Jr., Fail, P S, Beyer, M G, et al. New approach to preoperative vascular exclusion for carotid body tumor. J Vasc Surg, 2003; 38(2): 389–391.CrossRefGoogle ScholarPubMed
Cohen, J E, Ferrario, A, Ceratto, R, et al. Covered stent as an innovative tool for tumor devascularization and endovascular arterial reconstruction. Neurol Res, 2003; 25(2): 169–172.CrossRefGoogle ScholarPubMed
Cohen, J E, Spektor, S, Valarezo, J, et al. Endolymphatic sac tumor: Staged endovascular-neurosurgical approach. Neurol Res, 2003; 25(3): 237–440.CrossRefGoogle ScholarPubMed
Chaloupka, J C, Putman, C M, Citardi, M J, et al. Endovascular therapy for the carotid blowout syndrome in head and neck surgical patients: Diagnostic and managerial considerations. AJNR Am J Neuroradiol, 1996; 17(5): 843–852.Google ScholarPubMed
Chaloupka, J C, Roth, T C, Putman, C M, et al. Recurrent carotid blowout syndrome: Diagnostic and therapeutic challenges in a newly recognized subgroup of patients. AJNR Am J Neuroradiol, 1999; 20(6): 1069–1077.Google Scholar
Cohen, J and Rad, I. Contemporary management of carotid blowout. Curr Opin Otolaryngol Head Neck Surg, 2004; 12(2): 110–115.CrossRefGoogle ScholarPubMed
Maran, A G, Amin, M, and Wilson, J A. Radical neck dissection: A 19-year experience. J Laryngol Otol, 1989; 103(8): 760–764.CrossRefGoogle ScholarPubMed
Chang, F C, Lirng, J F, Tai, S K, et al. Brain abscess formation: A delayed complication of carotid blowout syndrome treated by self-expandable stent-graft. AJNR Am J Neuroradiol, 2006; 27(7): 1543–1545.Google ScholarPubMed
Chang, F C, Lirng, J F, Luo, C B, et al. Carotid blowout syndrome in patients with head-and-neck cancers: Reconstructive management by self-expandable stent-grafts. AJNR Am J Neuroradiol, 2007; 28(1): 181–188.Google ScholarPubMed
Desuter, G, Hammer, F, Gardiner, Q, et al. Carotid stenting for impending carotid blowout: Suitable supportive care for head and neck cancer patients?Palliat Med, 2005; 19(5): 427–429.CrossRefGoogle ScholarPubMed
Kim, H S, Lee, D H, Kim, H J, et al. Life-threatening common carotid artery blowout: Rescue treatment with a newly designed self-expanding covered nitinol stent. Br J Radiol, 2006; 79(939): 226–231.CrossRefGoogle ScholarPubMed
Lesley, W S, Chaloupka, J C, Weigele, J B, et al. Preliminary experience with endovascular reconstruction for the management of carotid blowout syndrome. AJNR Am J Neuroradiol, 2003; 24(5): 975–981.Google ScholarPubMed
Warren, F M, Cohen, J I, Nesbit, G M, et al. Management of carotid “blowout” with endovascular stent grafts. Laryngoscope, 2002; 112(3): 428–433.CrossRefGoogle ScholarPubMed
Simental, A, Johnson, J T, and Horowitz, M. Delayed complications of endovascular stenting for carotid blowout. Am J Otolaryngol, 2003; 24(6): 417–419.CrossRefGoogle ScholarPubMed
Parkin, D M, Bray, F, Ferlay, J, et al. Estimating the world cancer burden: Globocan 2000. Int J Cancer, 2001; 94(2): 153–156.CrossRefGoogle ScholarPubMed
Seiwert, T Y, Salama, J K, and Vokes, E E. The chemoradiation paradigm in head and neck cancer. Nat Clin Pract Oncol, 2007; 4(3): 156–171.CrossRefGoogle ScholarPubMed
Sullivan, R D. Continuous intra-arterial infusion chemotherapy of head and neck cancer. Trans Am Acad Ophthalmol Otolaryngol, 1962; 66: 111–117.Google ScholarPubMed
Klopp, C T, Smith, D F, and Alford, T C. Palliation achieved in carcinoma of the head and neck with intra-arterial chemotherapy. Am J Surg, 1961; 102: 830–834.CrossRefGoogle ScholarPubMed
Kerber, C W, Wong, W H, Howell, S B, et al. An organ-preserving selective arterial chemotherapy strategy for head and neck cancer. AJNR Am J Neuroradiol, 1998; 19(5): 935–941.Google ScholarPubMed
Alkureishi, L W, Bree, R, and Ross, G L. RADPLAT: An alternative to surgery?Oncologist, 2006; 11(5): 469–480.CrossRefGoogle Scholar
Robbins, K T. Is high-dose intensity intraarterial cisplatin chemoradiotherapy for head and neck carcinoma feasible?Cancer, 2005; 103(3): 447–450.CrossRefGoogle ScholarPubMed
Robbins, K T, Kumar, P, Harris, J, et al. Supradose intra-arterial cisplatin and concurrent radiation therapy for the treatment of stage IV head and neck squamous cell carcinoma is feasible and efficacious in a multi-institutional setting: Results of Radiation Therapy Oncology Group Trial 9615. J Clin Oncol, 2005; 23(7): 1447–1454.CrossRefGoogle Scholar
Robbins, K T, Storniolo, A M, Kerber, C, et al. Phase I study of highly selective supradose cisplatin infusions for advanced head and neck cancer. J Clin Oncol, 1994; 12(10): 2113–2120.CrossRefGoogle ScholarPubMed
Robbins, K T, Kumar, P, Regine, W F, et al. Efficacy of targeted supradose cisplatin and concomitant radiation therapy for advanced head and neck cancer: The Memphis experience. Int J Radiat Oncol Biol Phys, 1997; 38(2): 263–271.CrossRefGoogle ScholarPubMed
Robbins, K T, Kumar, P, Wong, F S, et al. Targeted chemoradiation for advanced head and neck cancer: Analysis of 213 patients. Head Neck, 2000; 22(7): 687–693.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Rasch, CR SC, Schornagel, J H, et al. Intra-arterial versus intravenous chemoradiation for advanced head and neck cancer, early results of a multi-institutional trial [abstract]. Int J Radiat Oncol Biol Phys, 2006; 66: 51–52.Google Scholar

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