Yathiraj Prahlad H, Ail Sandeep, Singh Anshul, Mamidipudi Vidyasagar
Department of Radiotherapy and Oncology, Manipal University, Kasturba Medical College, Manipal, Karnataka, India.
BMJ Case Rep. 2017 Aug 11;2017:bcr-2017-221284. doi: 10.1136/bcr-2017-221284.
Upper tracheal malignancies are rare, and long-term survival is even rarer, especially among the unresectable malignancies. A 66-year-old chronic smoker was diagnosed as a locally advanced, non-metastatic squamous cell carcinoma of the upper trachea. Being unresectable, he was treated with six cycles of concurrent weekly cisplatin and three-dimensional conformal radiotherapy to a dose of 60 Gy in 30 fractions over 6 weeks. Follow-up imaging at 6 and 12 months revealed no disease. Our patient is presently 36 months post-treatment and is disease free without tracheal necrosis, fistula or radiation pneumonitis but developed hypothyroidism and is presently euthyroid. Concurrent chemoradiotherapy appears safe up to 3 years at least without any necrosis and is effective in controlling local disease. Meticulous planning obviates the need for higher technology like motion management techniques or intensity-modulated radiotherapy.
上段气管恶性肿瘤较为罕见，长期生存更是少见，尤其是在不可切除的恶性肿瘤中。一名66岁的长期吸烟者被诊断为上段气管局部晚期非转移性鳞状细胞癌。由于无法切除，他接受了六个周期的同步化疗，每周一次顺铂，并接受三维适形放疗，在6周内分30次给予60 Gy的剂量。6个月和12个月的随访影像学检查未发现疾病。我们的患者目前处于治疗后36个月，无疾病，无气管坏死、瘘管或放射性肺炎，但出现了甲状腺功能减退，目前甲状腺功能正常。同步放化疗至少在3年内似乎是安全的，没有任何坏死，并且在控制局部疾病方面有效。精心的计划避免了对运动管理技术或调强放疗等更高技术的需求。
