Innovative application of internal carotid artery embolization in salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: A case-matched comparison.

Background The efficacy and safety of internal carotid artery (ICA) embolization as a treatment strategy in recurrent nasopharyngeal carcinoma (rNPC) patients with tumors invading the ICA remain unclear. Methods We enrolled all rNPC patients with tumors invading the ICA, who underwent salvage endoscopic surgery. Using propensity scores to adjust for specific potential prognostic factors, a well-balanced cohort of 42 patients with limited rNPC was formed by matching each patient who underwent ICA embolization (study group) with one who did not (control group). The survival rates and common treatment-related complications were compared between the two groups. Results The cohort included patients with the following tumor stages: rT2 (n = 3), rT3 (n = 24), and rT4 (n = 15). During a median follow-up of 15 months (2-63), the 3-year overall survival and progression-free survival rates were significantly higher in the ICA embolization group than in the ICA non-embolization group (72.4% vs. 17.8% and 53.4% vs. 33.0%, respectively; P = 0.022 and P = 0.006, respectively). Additionally, the incidence of treatment-related complications such as nasal obstruction, nasopharyngeal hemorrhage, and nasopharyngeal necrosis was significantly lower in the ICA embolization group than in the non-embolization group (P = 0.001, P = 0.014, and P = 0.038, respectively). Conclusions The innovative application of ICA embolization in endoscopic surgery in patients with rNPC invading the ICA significantly improved patient survival and reduced the risk of treatment-related complications. Therefore, this may be a safe and effective method with potential to improve the outcomes in rNPC patients. This article is protected by copyright. All rights reserved.