Spinelli Gian Paolo, Miele Evelina, Prete Alessandra Anna, Lo Russo Giuseppe, Di Marzo Alessandro, Di Cristofano Claudio, Tomao Silverio
UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, LT, Italy.
Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
J Med Case Rep. 2019 Mar 6;13(1):52. doi: 10.1186/s13256-019-1996-9.
Adenoid cystic carcinoma of the trachea is a rare tumor, characterized by slow growth and low rate of local and distant metastasis. When achievable, complete surgical resection represents the optimal treatment approach, with the highest results in terms of overall survival. Radiation therapy is a reasonable alternative in cases of inoperable disease.
We report a case of an 82-year-old white man affected by primary adenoid cystic carcinoma of the trachea, treated with debulking surgery and radiotherapy on the residual disease. A three-dimensional conformal radiation therapy was conducted. The total dose amounted to 70 Gy, administered in 35 fractions of 2 Gy. The medium doses given to the esophagus and lungs were 23 Gy and 4.2 Gy respectively. The maximum dose delivered to the spinal cord was 31 Gy with satisfactory results in terms of local control of the disease.
A combined approach of surgical resection followed by radiotherapy on the residual disease provided an excellent result in terms of disease control, quality of life, and overall survival in a patient with locally advanced tracheal adenoid cystic carcinoma.
气管腺样囊性癌是一种罕见肿瘤，其特点是生长缓慢，局部和远处转移率低。若能实现，完整手术切除是最佳治疗方法，总体生存率最高。对于无法手术的病例，放射治疗是一种合理的替代方案。
我们报告一例82岁白人男性原发性气管腺样囊性癌患者，接受了减瘤手术及对残留病灶的放射治疗。进行了三维适形放射治疗。总剂量达70 Gy，分35次给予，每次2 Gy。给予食管和肺的中位剂量分别为23 Gy和4.2 Gy。脊髓接受的最大剂量为31 Gy，在疾病局部控制方面取得了满意结果。
对于局部晚期气管腺样囊性癌患者，手术切除后对残留病灶进行放射治疗的联合方法在疾病控制、生活质量和总体生存方面取得了优异结果。
