Lung Cancer |

Radiation Therapy Is an Effective Adjuvant Modality Following Airway Stenting for Malignant Central Airway Obstruction (CAO) FREE TO VIEW

Andrew Evans, MD; Sadiq Rehmani, MBBS; Hassan Sheikh Moghaddas, MD; Jordan Sasson, MD; Sarah Almubarak, MD; Shahzad Razi, MD; Adnan Al-Ayoubi, MD; Faiz Bhora, MD
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St. Lukes-Roosevelt Hospital Center, New York, NY

Chest. 2014;145(3_MeetingAbstracts):347A. doi:10.1378/chest.1835538
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SESSION TYPE: Slide Presentations

PRESENTED ON: Saturday, March 22, 2014 at 02:15 PM - 03:45 PM

PURPOSE: We have previously shown that timely restoration of airway patency with airway stenting in patients with malignant CAO provides both immediate palliation but also leads to improved survival. Radiation Therapy (RT) has also been used to improve airway patency in such cases. In this study, we analyze the additive salutary effects of combining airway stenting with RT for malignant CAO.

METHODS: We performed a retrospective review of patients who underwent airway stenting for malignant CAO at our institution over a period of 5 years. Preoperative characteristics, pathological subtype, disease stage and Medical Research Council (MRC) dyspnea scores were recorded. Treatment details were noted for patients who received RT post-stenting. Kaplan-Meier and Cox-regression analyses were performed to compare survival between patients who received RT and who did not.

RESULTS: Overall 102 patients underwent airway stenting for CAO. All patients had bulky IIIA or higher stage disease with >80% airway stenosis and a mean MRC dyspnea score of 4. Successful airway patency was achieved in all cases. Patients who received RT (n = 42) after stent placement had a longer median OS compared to those without RT (146 vs. 82 days). Sub-group analysis based on pathological subtype revealed significantly increased survival in patients with small-cell lung cancer (146 vs. 30 days, p <0.05) and a trend towards increased survival in patients with squamous cell histology (328 vs. 92 days).

CONCLUSIONS: In our cohort, the addition of RT in conjunction with airway stenting resulted in improved survival compared to stenting alone in patients with malignant CAO. Patients with small cell lung carcinoma and squamous cell carcinoma appear to derive more benefit.

CLINICAL IMPLICATIONS: RT can serve as an adjunctive measure along with airway stenting for patients with malignant CAO. Combination of RT and airway stenting is a safe multimodal approach and can provide additional survival benefits in such patients.

DISCLOSURE: The following authors have nothing to disclose: Andrew Evans, Sadiq Rehmani, Hassan Sheikh Moghaddas, Jordan Sasson, Sarah Almubarak, Shahzad Razi, Adnan Al-Ayoubi, Faiz Bhora

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