PURPOSE: Adenoid cystic carcinoma(ACC) of the trachea is a slowly growing tumor and airway narrowing is one of the main cause of death. The purpose of this study was to assess the treatment outcomes of tracheal stent insertion before or after radiation therapy (RT) in patients with ACC of the trachea.
METHODS: We retrospectively reviewed clinical characteristics and treatment outcomes of patients with histologically-proven ACC of the trachea who underwent tracheal stent insertion and RT between December 1994 and March 2011 at Samsung Medical Center.
RESULTS: Twenty-two patients were included in the analysis. 11 patients were male and the median age was 54 years. The median follow-up period was 25.5 (1-126) months. We compared 8 patients who underwent tracheal stent insertion after radiation therapy (post-RT stented group) and 14 patients who underwent tracheal stent insertion before radiation therapy (pre-RT stented group). There was no difference between two groups in mean age (52±15 vs. 56±11, p=0.502). However, there were more men and smokers in the patients who underwent tracheal stent before radiation therapy (10/14 vs. 1/8, p=0.024, 9/14 vs. 1/8, p=0.031). The 1-, 3- and 5-year overall cumulative survival rate in pre-RT stented patients (85.1%, 73% and 73%) were longer than in whom stent was inserted after RT (72.9%, 36.5% and 18.2%).
CONCLUSIONS: Tracheal stent insertion before radiation therapy offers the more chance for long-term survival in patients with ACC of the trachea.
CLINICAL IMPLICATIONS: Earlier tracheal stenting improves survival in patients with tracheal ACC when definitive radiation therapy is indicated.
DISCLOSURE: The following authors have nothing to disclose: Boksoon Chang, Jun Whi Song, Jong Hoo Lee, Sang-Won Um, Won-Jung Koh, Gee Young Suh, Man Pyo Chung, O Jung Kwon, Jungho Han, Hojoong Kim
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