Radiotherapy for Primary Tracheal Carcinoma: Experience at a Single Institution

Abstract

Background: There is limited understanding of tracheal carcinoma (TC) because of its rarity. We examined the efficacy of radiotherapy (RT) for patients with primary TC. Methods: We analyzed the records of 32 patients with primary TC who received RT at our center between November 1996 and December 2016. Results: Thirteen patients received adjuvant RT and 18 received definitive RT. Eight patients achieved complete remission (CR) after definitive RT. Among all patients, the 5-year overall survival (OS) rate was 46.9% and the locoregional progression free survival (LRPFS) rate was 68.1%. Univariate analysis indicated the 5-year OS was better in those with adenoid cystic adenocarcinoma than squamous cell carcinoma ( P = 0.001); the 5-year LRPFS was better in patients who received surgical resection than those who did not (92.9% vs 46.4%, P = 0.013) and in patients who received postoperative RT than in those who received definitive RT (91.7% vs 50.1%, P = 0.038). A sub-group univariate analysis indicated the 5-year PFS was better for those who received at least 68 Gy of radiation (44.4% vs 13.0%, P = 0.044). Patients who achieved CR had a better 5-year PFS than those who did not (57.1% vs 10%, P = 0.006). No patients had a toxicity of grade 3 or more. Conclusions: Adjuvant and definitive RT are safe and effective treatments for TC. Patients who received dosages of 68 Gy or more and who had complete tumor regression following definitive RT seemed to have better long-term survival.

Tracheal cancer: a rare and deadly but potentially curable disease that also affects younger people

“…The present finding from the univariable analysis of the decreased risk of death in those with ACC has been found by others [ 26 ]. This significance, however, was not present in the multivariable analysis where age and treatment modality also were included in the predictors.…”

Role of radiation alone versus concurrent chemoradiotherapy in surgically ineligible patients with tracheobronchial squamous cell carcinoma

“…It has been known that tracheal cancer exhibits not only a substantial occurrence of local failure but also signi cant rates of distant failure after RT [14,21]. In the current study, we established that local progression was reduced from 42.9-28.6% and distant progression from 57.1-14.3% when concurrent chemotherapy was added to RT, although this was not statistically signi cant due to the small number of cases (Table 2).…”

“…Our current study revealed a tendency towards improved PFS and OS when concurrent chemotherapy was administered alongside RT, indicating that CCRT may be an effective treatment option for patients who are not eligible for surgery. Some hospital data-based studies and case reports have reported clinical outcomes of patients undergoing CCRT, but without systematic statistical analysis, while one study using the National Cancer Database found superior median OS for CCRT compared to RT alone (Supplementary Table 5) [14][15][16][17][18][19][20][21][22]. Therefore, to our knowledge, this is the rst clinical report comparing CCRT with RT alone and demonstrating the bene ts of CCRT exclusively in patients with squamous cell carcinoma among tracheobronchial cancers.…”

Trachealtumoren

“…Damit die erforderlichen hohen Strahlendosen sicher appliziert werden können, kommen in aller Regel Techniken der Präzisionsstrahlentherapie wie fluenzmodulierte Verfahren (VMAT/IMRT) oder Partikelbestrahlungen zur Anwendung [32,33]. Angestrebt werden in der Situation der primär definitiven Strahlentherapie Dosen > 60 Gy, wobei auch jenseits von 66 Gy noch eine positive Dosiswirkung erwartet werden darf [34].…”