Related Experiment Videos
Management of epistaxis in Rendu-Osler disease: is brachytherapy effective?
S Pohar1, J J Mazeron, M Ghilezan
1Department of Radiation Oncology, Cleveland Clinic, OH 44195.
International Journal of Radiation Oncology, Biology, Physics
|December 1, 1993
Summary
Intranasal brachytherapy effectively managed hereditary hemorrhagic telangiectasia (HHT)-related epistaxis in 43 patients. This treatment offered a median 24-month recurrence-free interval, with minimal complications like septal perforation.
Area of Science:
- Otorhinolaryngology
- Radiation Oncology
- Medical Genetics
Background:
- Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler disease, is a genetic disorder causing abnormal blood vessel formation.
- Epistaxis is a common and often severe symptom in HHT patients, significantly impacting quality of life.
Purpose of the Study:
- To evaluate the efficacy and safety of intranasal brachytherapy for managing recurrent epistaxis in patients with Rendu-Osler disease.
- To assess the long-term outcomes of this treatment modality.
Main Methods:
- Retrospective review of 43 HHT patients treated with intranasal brachytherapy between 1971-1991.
- Utilized 192Ir sources delivered via intranasal catheters with computer-assisted dosimetry.
- Dose rates ranged from 0.16-0.63 Gy/h, with single application doses between 15-35 Gy.
Main Results:
- A median epistaxis recurrence-free interval of 24 months (range: 6-178 months) was observed.
- No correlation was found between prescribed dose and epistaxis control rate.
- The primary complication was septal perforation in 4 patients, with one case linked to prior nasal coagulation.
Conclusions:
- Intranasal brachytherapy is a valuable therapeutic option for controlling severe epistaxis in patients with Rendu-Osler disease.
- The treatment demonstrates a favorable risk-benefit profile for managing this challenging symptom.