Hetnał Marcin, Kielaszek-Ćmiel Alicja, Wolanin Magdalena, Korzeniowski Stanisław, Brandys Piotr, Małecki Krzysztof, Sas-Korczyńska Beata, Chłosta Monika, Kokoszka Anna
Radiation Oncology Department, Centre of Oncology, Krakow, Poland.
Breast and Thoracic Cancer Unit, Centre of Oncology, Krakow, Poland.
Rep Pract Oncol Radiother. 2010 Oct 6;15(5):113-8. doi: 10.1016/j.rpor.2010.08.005. eCollection 2010.
To assess the results of tracheal cancer patients treatment and factors influencing prognosis.
Primary malignant neoplasms of the trachea are rare. The treatment of choice for tracheal carcinomas is resection. Radiation therapy is recommended as a part of radical treatment or for palliation of symptoms.
Between 1962 and 2006, 50 patients diagnosed with tracheal cancer were treated at the Centre of Oncology in Krakow. The analysis focused on locoregional recurrence-free survival (LRRFS), disease free survival (DFS) and overall survival (OS). Survival rates, univariate and multivariate analyses of prognostic factors were performed using the Kaplan-Meier method, the log rank test and Cox's proportional hazard method, respectively. For over 40 years, patients were treated using different modalities: surgery followed by radiotherapy (6%), radiotherapy (78%), chemoradiotherapy (8%), and symptomatic treatment (8%).
The 5-year LRRFS was 18%, DFS was 15% and OS was 17%. gender (favoured females) was the only prognostic factor for LRRFS. For OS, the independent prognostic factors were performance status (favoured Karnofsky higher than 80), stage and year of start of the treatment (later than 1988 vs. earlier - 5-year OS 20% vs. 12%). 5-year OS in the following (strongly differentiated over the time) treatment modalities were: surgery followed by radiotherapy (66%), radiotherapy (16%), chemoradiotherapy (0%), and symptomatic treatment (0%). Of 44 patients treated with radiotherapy symptomatic partial response was observed in 32 patients and follow-up imaging studies revealed complete response in 5 patients, partial response in 25, stable disease in 4 or progressive disease in 4.
Radical treatment in patients in early stage and good performance status seems to be correlated with the improvement of survival. However, despite the fact that results of treatment are poor, radiotherapy offers symptomatic improvement.
评估气管癌患者的治疗结果及影响预后的因素。
原发性气管恶性肿瘤较为罕见。气管癌的首选治疗方法是手术切除。放射治疗被推荐作为根治性治疗的一部分或用于缓解症状。
1962年至2006年间，50例诊断为气管癌的患者在克拉科夫肿瘤中心接受治疗。分析重点为局部区域无复发生存期（LRRFS）、无病生存期（DFS）和总生存期（OS）。分别采用Kaplan-Meier法、对数秩检验和Cox比例风险法进行生存率分析、预后因素的单因素和多因素分析。40多年来，患者接受了不同的治疗方式：手术加放疗（6%）、放疗（78%）、放化疗（8%）和对症治疗（8%）。
5年LRRFS为18%，DFS为15%，OS为17%。性别（女性更有利）是LRRFS的唯一预后因素。对于OS，独立预后因素为体能状态（Karnofsky评分高于80更有利）、分期和治疗开始年份（1988年以后与之前相比——5年OS分别为20%和12%）。以下（随时间显著分化）治疗方式的5年OS分别为：手术加放疗（66%）、放疗（16%）、放化疗（0%）和对症治疗（0%）。在44例接受放疗的患者中，32例观察到症状部分缓解，随访影像学检查显示5例完全缓解，25例部分缓解，4例病情稳定，4例病情进展。
早期且体能状态良好的患者进行根治性治疗似乎与生存率的提高相关。然而，尽管治疗结果不佳，但放疗可改善症状。
