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Turkish Journal of Cancer
2000, Volume 30, Number 2, Page(s) 75-80
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External radiotherapy and HDR Ir-192 brachytherapy boost in primary tracheal tumors
FARUK ZORLU1, MUSTAFA CENGİZ1, SALİH EMRİ2, AYŞE KARS3, FADIL AKYOL1
Departments of 1Radiation Oncology,2Chest Diseases and 3Medical Oncology, Hacettepe University Faculty of Medicine, Ankara-Turkey

Primary tracheal tumors are rare and often diagnosed after regional or distant metastasis has occurred. The prognosis is generally poor with overall survival of 10-20% at two years. The primary treatment is surgical resection of the tumor. Radiotherapy is usually employed in inoperable cases or as an adjunct treatment to surgery. Between 1994 and 1998, eight patients with primary tracheal tumors were treated with curative intent. There were six male and two female patients who were aged between 34 and 74 (median 61) years with a minimum Karnofsky performance status score of 90. The histopathologic subtype of the lesion was squamous cell carcinoma in four and adenoid cystic carcinoma in four cases. Location of the tumor was mostly on distal trachea that was in four patients and median tumor extent was three cm. Seven patients received a total dose of 50 Gy; one patient who did not accept brachytherapy was given 60 Gy external beam irradiation. Endobronchial high dose rate (HDR) brachytherapy was prescribed as 15 Gy in 3 fractions. The median survival in this group of patients is 15 months. All patients were evaluated as in complete remission, after completion of treatment. However, locoregional relapse was seen in five patients after a median of 14 months (5.5-22 months) of radiotherapy. Four patients who experienced locoregional failure had originally received brachytherapy as a boost. The remaining patient was the one only treated by external irradiation. We have not seen any treatment related major complication. Our data show that addition of brachytherapy increases complete remission rate without significant increase in serious toxicities.

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