Causes of epistaxis in patients with nasopharyngeal carcinoma after radiotherapy

The main treatment for nasopharyngeal carcinoma is radiotherapy, but after radiotherapy, there will be side effects and complications, among which nose bleeding is a more common one. So how is this caused?

1. Recurrence of nasopharyngeal carcinoma: Recurrence of nasopharyngeal carcinoma can cause bleeding. This is because the tumor will continue to grow during recurrence and invade the fragile blood vessels in the nasal cavity. If touched or rubbed by airflow, the blood vessels will rupture and cause bleeding.

2. Side effects of radiotherapy: High-dose radiotherapy not only kills or injures cancer cells, but also damages normal cells, causing necrosis of the nasopharyngeal mucosa, difficulty in tissue repair, and the formation of ulcers that do not heal for a long time. The main parapharyngeal blood vessels are exposed and the walls of the vessels become hard. When the tumor disappears and disintegrates after radiotherapy, the blood vessel walls cannot be effectively repaired, causing blood vessels to rupture and bleeding.

3. Pathological changes in blood vessels: Pathological changes in the blood vessels on the surface of the nasopharynx are also a cause of bleeding. Studies have found that due to long-term compression of the nasopharyngeal blood vessels by cancer, it will cause micro-vascular proliferation and varicose veins, tortuosity and twisting, resulting in uneven thickness of the blood vessel walls, which are extremely prone to damage and bleeding.

4. Nasopharyngeal tissue biopsy: Nasopharyngeal tissue biopsy is the direct cause of nosebleeds. If blood vessels are accidentally damaged during the biopsy, bleeding may occur.

5. In addition, the age of NPC patients and the stage of tumor are also closely related to NPC bleeding. The older the age and the later the stage, the greater the possibility of bleeding.