Results of treating primary tumours of the trachea by irradiation.

Rostom, A.Y.; Morgan, RM

doi:10.1136/thx.33.3.387

Cited by 57 publications

(22 citation statements)

References 5 publications

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“…Fields et al [7] reported that 6 of 7 patients attained a complete response and ultimate local control with a radiation dose of 60 Gy or greater, compared with 1 of 11 patients with a radiation dose of less than 60 Gy. Better response rates with doses of 60 Gy or higher have also been reported in other studies [8,16,20,21]. However, the improvements in control rates have been achieved with a concomitant increase in the incidence of complications, the most common being tracheal stenosis requiring dilatation.…”

Section: Discussionmentioning

confidence: 67%

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Primary Malignant Tumors of the Trachea – The Tata Memorial Hospital Experience

Thotathil¹,

Agarwal

Shrivastava

et al. 2004

Med Princ Pract

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Objective: Primary tumors of the trachea are extremely rare. Treatment methods vary considerably and few studies have sought to provide adequate guidelines. This study reviews the records of patients treated for tracheal cancer at the Tata Memorial Hospital (TMH), Mumbai, India. Subjects and Methods: Fifteen patients with primary tracheal malignancies were identified in the TMH database during the period from 1983 to 2000. They were predominantly males (87%) belonging to an older age-group (67% above 40 years). Common presenting symptoms were cough, hoarseness, hemoptysis and indications of airway obstruction. Squamous cell carcinoma was the commonest histologic subtype (40%) followed by adenoid cystic carcinoma (27%). Ten patients received radical treatment. One patient underwent surgery (resection and anastomosis) and received postoperative radiotherapy. Another was explored but was found to be unresectable and was 1 of 2 patients treated with chemotherapy and radiotherapy. Laser resections and radiotherapy were used in 2 patients while 4 patients were managed with radiotherapy alone. One patient was treated elsewhere. The majority of patients (8/9) were treated with locoregional fields and doses ranging from 40 to 60 Gy (median 50 Gy). Two patients also received intraluminal brachytherapy, 1 as part of initial treatment and another for recurrence. Results: Only 5 patients treated at TMH (5/9) achieved local control of their disease. Follow-up times ranged from 1 month to 134 months, median of 38 months. Distant metastases were identified in 4 patients (bone n = 1 and lung n = 3). Median survival was 38 months. Overall survival at 5 years was 37% by Kaplan-Meier method, but this figure should be treated with caution since only 6 patients had a follow-up of more than 2 years. Conclusion: Tracheal cancer is a rare malignancy. Radiation therapy is a reasonably effective modality for unresectable disease.

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Section: Discussionmentioning

confidence: 67%

“…However, the improvements in control rates have been achieved with a concomitant increase in the incidence of complications, the most common being tracheal stenosis requiring dilatation. Esophageal strictures, tracheo-esophageal fistulae and arterial rupture have also been reported [7,8,20].…”

Section: Discussionmentioning

confidence: 99%

Primary Malignant Tumors of the Trachea – The Tata Memorial Hospital Experience

Thotathil¹,

Agarwal

Shrivastava

et al. 2004

Med Princ Pract

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“…''Radiation bronchitis'', manifesting itself as a reddened hyperaemic airway mucosa and thickened bronchial secretions, following therapeutic external-beam radiation doses (50-60 Gy) applied to the lung has seldom been described. However, only a few articles have reported stenosis in proximal bronchi 6-15 months after external-beam radiation for lung cancer using 80 Gy doses [6], or tracheal stenosis after irradiation of tracheal cancers with doses ranging 50-70 Gy [7,8]. No extrinsic compressions were noted.…”

Section: Discussionmentioning

confidence: 99%

Bronchial stenosis and sclerosing mediastinitis: an uncommon complication of external thoracic radiotherapy

Dechambre

Dorzee

et al. 1998

Eur Respir J

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aaThoracic radiotherapy is one of the major treatment modalities in lung cancer. Radiation pneumonitis and fibrosis are well-known side-effects. ''Radiation bronchitis" in the form of inflammatory reaction of the airways mucosa following therapeutic external-beam radiation and highdose endobronchial radiation (brachytherapy) has also been reported. Otherwise, there is very little mention in the literature regarding the effects of the radiation on the airways.In this article, we report a case of sclerosing mediastinitis with bronchial stenosis discovered 1 yr after external thoracic radiotherapy. Case reportA right upper lobectomy for a peripheral adenocarcinoma of the ventral segment of the right upper lobe was performed on a 59 yr old woman in November 1992. This patient had a relevant medical history of a 40 pack-year history of smoking, a left sylvian stroke in 1988, and an inferior myocardial infarction in 1990. The postoperative staging (tumour, node, metastasis (TNM) classification), using a systematic mediastinal sampling, was T3N0M0 in view of an extension to the parietal pleura and the absence of metastases.External radiation therapy was, therefore, performed using an 18 MeV photon linear accelerator. Doses of 2 Gray (Gy) each were delivered in 27 fractions by a combination of anteroposterior parallel opposed fields (16 fractions), anterior direct fields (seven fractions), and anteroposterior opposed oblique angle wedge fields (four fractions). The total dose applied to the tumour bed and the right hilum was around 57 Gy. The total dose applied to the paratracheal left chain was approximately 45 Gy, and the spinal cord received about 42 Gy.In November 1993, the patient complained of persistent cough and a gradual onset of dyspnoea. On physical examination, a decrease in the breath sounds over the right lung was noted, the left lung being clear; no other findings of note were detected. Blood results were normal except for a slight elevation of hepatic enzymes. The carcinoembryonic antigen (CEA) was 10 ng·mL -1 (normal values <7 ng·mL -1 ), the level before the operation being 15 ng·mL -1 . The Mantoux test was negative.Chest radiography disclosed a right hilar enlargement and a right apical thickening. Thoracic computed tomography (CT) showed the presence of a right paratracheal mass with extension around the right main-stem bronchus, the lumen of which was severely narrowed ( fig. 1). The subcarinal area was also involved. A slight heterogeneous enhancement was observed after administration of contrast material. An area of soft tissue density containing dilated bronchi, with a straight edge corresponding to radiation fibrosis localized in the middle lobe with adjacent pleural thickening was present conforming to the radiation port. Magnetic resonance imaging (MRI) revealed that this mass had a low intensity signal both in T1 and T2 weighted images. This short T2 relaxation time was said to be suggestive of a benign fibrous process.Fibreoptic examination revealed an 80% extrinsic stenosis of the right ma...

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“…Primary cancer of the trachea is extremely rare (1); accounting for 0.1-0.4% of all newly diagnosed airway cancers, or 2.6 new cases per 1,000,000 people per year (2,3). In tracheal carcinogenesis, malignant transformation may be idiopathic or due to carcinogen exposure, immunosuppressant use, radiation or smoking (4,5).…”

Section: Introductionmentioning

confidence: 99%

Papillary Squamous Cell Carcinoma of the Trachea Associated with Human Papillomavirus-18 Infection

et al. 2013

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A 75-year-old man presented with the chief complaints of coughing and dyspnea. Chest computed tomography revealed narrowing of the trachea. A tumor measuring 40×33×15 mm in size that caused -90% reduction in the cross-sectional area of the trachea 4 cm above the carina was cauterized with high-frequency electrocautery via a rigid bronchoscope. A pathological examination revealed papillary squamous cell carcinoma with immunohistochemical p16 overexpression. Multiplex polymerase chain reaction confirmed human papillomavirus type 18 DNA in the tumor. At the 12-month follow-up visit following the administration of radiotherapy, the patient exhibited no local recurrence or distant metastasis.

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Results of treating primary tumours of the trachea by irradiation.

Cited by 57 publications

References 5 publications

Primary Malignant Tumors of the Trachea – The Tata Memorial Hospital Experience

Primary Malignant Tumors of the Trachea – The Tata Memorial Hospital Experience

Bronchial stenosis and sclerosing mediastinitis: an uncommon complication of external thoracic radiotherapy

Papillary Squamous Cell Carcinoma of the Trachea Associated with Human Papillomavirus-18 Infection

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