High Dose-Rate Brachytherapy as a Treatment Option in Primary Tracheal Tumors

Abstract

PURPOSE: To present experience with high dose-rate endobronchial brachytherapy in the treatment of primary tracheal tumors. PATIENTS AND METHODS: Four patients with nonresected primary tracheal tumors are presented: 2 cases of squamous cell carcinoma of the trachea, 1 of recurrent adenoid cystic carcinoma, and 1 with recurrent plasmacytoma. All received brachytherapy, alone or as a boost for primary irradiation, in 3 or 4 fractions of 7.5 Gy, calculated at a depth of 1 cm. Followup was considered to start from the end of brachytherapy. RESULTS: Local control was achieved in all cases at the time of first bronchoscopic evaluation. Two patients with squamous cell carcinoma died at 6 th and 33 rd months after brachytherapy, respectively. The first had no evidence of disease, and the latter had local recurrence. The other 2 patients were alive after 64 and 110 months of follow-up, respectively, both with no evidence of disease. Tracheal stenosis developed in these 2 cases, 22 and 69 months after brachytherapy. Tracheal stent placement was needed only for the patient with an adenoid cystic carcinoma. CONCLUSIONS: Endobronchial high dose-rate brachytherapy may be used for tracheal tumors, even as a boost for external beam irradiation, or in recurrences. Local control in 3 out of 4 patients indicates that individual cases may benefit from the treatment. Long-term survival may also be expected, mainly for tumors with adenoid cystic histology.

Stent loaded with radioactive Iodine-125 seeds for adenoid cystic carcinoma of central airway: A case report of innovative brachytherapy

“…Thus, all layers of tracheal and bronchial wall were regarded as the PTV in our case with non-contrast CT pictures. It’s reported that a case of primary tracheal ACC was treated with high dose-rate brachytherapy, who developed tracheal stenosis 22 months after brachytherapy and had to be placed a tracheal stent ( 6 ). In contrast, our case wasn’t observed tracheal stenosis in the most recent follow-up, confirming the efficacy and safety of the innovative brachytherapy in the long term.…”

A rare cause of recurrent wheeze and seizures

“…Radiotherapy may be offered as a form of palliative therapy, or it may be offered postoperatively in cases where the tumour is not resectable, or in cases where metastasis of the disease has occurred 11. Chemotherapy with carboplatinum and paclitaxel, in conjunction with radiotherapy, has shown to be successful in some trials 12…”