Jang Jeong Yun, Pyo Hongryull, Yang Kyungmi, Noh Jae Myoung, Lee Jeong Ha
Department of Radiation Oncology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Thorac Dis. 2025 Mar 31;17(3):1312-1322. doi: 10.21037/jtd-24-1911. Epub 2025 Mar 27.
Primary tracheobronchial squamous cell carcinoma (SCC) is a rare and aggressive malignancy, with limited evidence guiding optimal treatment strategies. We aimed to evaluate treatment outcomes for primary tracheobronchial SCC, explicitly focusing on the potential benefits of adding concurrent chemotherapy to definitive radiotherapy (RT).
Nineteen patients with tracheobronchial SCC treated at the Samsung Medical Center between January 1995 and April 2023 were identified. Surgical interventions were determined using a multidisciplinary approach, and patients who were ineligible for surgery received RT with or without concurrent chemotherapy. The progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method.
Of the 19 patients included in the study 5 underwent surgery, whereas the remaining 14 underwent RT. For total patients, the median PFS and OS were 28.2 and 43.3 months, respectively. The 3-year OS rates were 16.7%, 83.3%, and 60.0% in the RT alone, concurrent chemoradiotherapy (CCRT), and surgery groups, respectively. With a median follow-up period of 19.1 months, eight patients experienced disease progression, with the lungs and trachea being the most common sites for recurrence. Univariate analysis demonstrated that large tumor size, low radiation dose, pretreatment stent insertion, and radiation-only treatment correlated with inferior survival. In the 12 patients receiving curative RT, a trend towards improved OS was observed in the CCRT group (RT alone CCRT; 25.0% 83.3% at 3 years, P=0.08).
CCRT may improve survival outcomes in patients with inoperable tracheobronchial SCC, offering a possible alternative to surgical interventions.
原发性气管支气管鳞状细胞癌（SCC）是一种罕见且侵袭性强的恶性肿瘤，指导最佳治疗策略的证据有限。我们旨在评估原发性气管支气管SCC的治疗结果，特别关注在根治性放疗（RT）中加用同步化疗的潜在益处。
确定了1995年1月至2023年4月在三星医疗中心接受治疗的19例气管支气管SCC患者。采用多学科方法确定手术干预措施，不符合手术条件的患者接受单纯放疗或同步放化疗。采用Kaplan-Meier法估计无进展生存期（PFS）和总生存期（OS）。
纳入研究的19例患者中，5例行手术治疗，其余14例行放疗。总体患者的中位PFS和OS分别为28.2个月和43.3个月。单纯放疗、同步放化疗（CCRT）和手术组的3年OS率分别为16.7%、83.3%和60.0%。中位随访期为19.1个月，8例患者出现疾病进展，肺和气管是最常见的复发部位。单因素分析表明，肿瘤体积大、放疗剂量低、治疗前置入支架和单纯放疗与较差的生存率相关。在12例接受根治性放疗的患者中，CCRT组观察到OS有改善趋势（单纯放疗与CCRT；3年时分别为25.0%与83.3%，P = 0.08）。
CCRT可能改善不可手术切除的气管支气管SCC患者的生存结局，为手术干预提供了一种可能的替代方案。
