From 1959 to 1986, 24 patients with primary malignant tumors of the trachea received radiotherapy as all or part of treatment. Common presentations included respiratory symptoms in 20 patients and hemoptysis in 15. Thirteen patients had squamous carcinomas with undifferentiated and adenoid cystic cancers in five and four patients, respectively. Overall actuarial survival was 45% at 1 year, 25% at 5 years, and 13% at 10 years. Survival was significantly correlated to histologic type (adenoid cystic versus squamous, P < 0.03), but not to tumor extent or to patient age or sex. Local control was attained in 10 of 24 patients overall and was more frequent for patients with tumors localized to the trachea and for patients who were treated with combined surgery and radiotherapy. For the 18 patients treated with radiotherapy alone, complete response (CR) was seen to be significantly (P < 0.001) related to dose: six of seven (86%) patients receiving 26000 cGy attained CR versus one of 11 (9%) receiving <6000 cGy. Three patients developed complications related to radiotherapy. Radiotherapy can provide durable local control of l o c a l i i tracheal tumors and should be considered for medically inoperable patients with localized tumors and for patients with high risk of recurrence after resection. Cancer 63:2429-2433, 1989. RIMARY CANCERS of the trachea are quite rare, ac-P counting. for 0.1 % to 0.4% of all malignancies.'.' Symptoms are subtle, and these tumors often are diagnosed at an advanced stage. With improved surgical techniques over the last two decades, surgery has become the primary treatment for tracheal tumors in many centers. ' ~ 7 After curative resection, 5-year survivals of 20% to 40% are reported for epidermoid carcinomas and 60% to 100% for adenoid cystic carcinomas.'94q5 However, ra-diotherapeutic techniques have also evolved over recent decades, and recent report^^.^ suggest good local control and potential cure for patients with tumors confined to the trachea. The current report describes our experience with irradiation of primary tracheal cancers and analyzes the effects of various tumor and treatment parameters on local control and survival. Materials and Methods From 1959 to 1986,24 patients with primary malignant tumors of the trachea received radiotherapy at the Ra-Presented at the 70th Annual Meeting of the American Radium Society ,

Background. Inflammatory carcinoma of the breast has been associated with a poor prognosis. Several therapeutic approaches have been under investigation in an effort to improve outcome.Methods. This is a retrospective analysis of 179 patients with histologically confirmed inflammatory carcinoma of the breast: 33 treated with irradiation alone, 35 with combined irradiation and chemotherapy, 25 with irradiation and surgery, and 86 with a combination of three modalities.Results. The 5-year disease free survival (DFS) rates were 40% for patients treated with three modalities, 24% for those treated with irradiation and surgery, and 6% for those treated with irradiation alone or in combination with chemotherapy without a surgical procedure. The 10-year DFS rates were 35' /0, 24%, and O%, respectively. Cause specific survival (CSS) curves closely follow the same trends. A clearly superior locoregional tumor control was observed in patients who underwent a surgical procedure: 79% with three modalities, 76% with irradiation and surgery, and only 30% with irradiation alone or in combination with chemotherapy. Distant metastasis occurred in 57% of the group treated with triple-modality therapy, 60% of those treated with irradiation plus surgery, and 85% of the patients treated with irradiation alone or in combination with chemotherapy. There was no significant correlation between the type of mastectomy or doses of irradiation and locoregional tumor control or survival. The significant morbidity of the trimodal ther-

From 1962 to 1984, 13 patients with juvenile nasopharyngeal angiofibroma (JNA) were treated with megavoltage radiation therapy. Follow-up ranged from 40 to 255 months (median, 136 months). Two patients received radiation therapy as the initial treatment; the other 11 patients had undergone unsuccessful previous surgical treatment (median, three resections). Gross tumor was evident at the start of radiation therapy in seven patients, and orbital, sphenoid sinus, or intracranial extension was noted in eight of 13 (62%). Doses ranged from 3,600 to 5,200 cGy (median, 4,800 cGy in daily fractions of 180-200 cGy). Tumor was controlled in 11 patients (85%) after irradiation. Two patients were treated with embolization for residual mass; both remained asymptomatic and without evidence of tumor 134 and 83 months after embolization, respectively. With the exception of xerostomia and caries, no significant chronic morbidity was seen. This review and other studies demonstrate that megavoltage radiation therapy is an effective and appropriate treatment for advanced and recurrent JNA; its routine use for early tumors remains controversial.

No abstract