Short-course Radiotherapy for Airway Stenting in Malignant Airway Obstruction: A Case Report and Literature Review.

Cancer diagnosis & prognosis Pub Date : 2024-05-03 eCollection Date: 2024-05-01 DOI:10.21873/cdp.10332
Giuseppe Facondo, Chiara Reverberi, Tino Ceschia, Giuseppe Parisi, Gianluca Vullo, Eugenia Moretti, Marco Trovò
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Abstract

Background: Malignant airway obstruction (MAO) secondary to tumor growth occurs in nearly a third of patients with lung cancer and portends a very poor prognosis if untreated. Treatment options include bronchoscopic intervention with tumor debulking, stent placement, endobronchial brachytherapy, or palliative radiotherapy.

Case report: This is a report of a 74-year-old woman with a medical history of metastatic lung adenocarcinoma, hospitalized for dyspnea, hemoptysis, and chest pain with a radiographic finding of MAO on chest X-ray and computed tomography. Patient underwent radiation with a total dose of 13 Gy in two once-weekly fractions of 6.5 Gy per fraction. Three days after the end of radiation treatment, chest X-ray showed a completely right lung re-expansion without atelectasis. Two weeks after radiotherapy treatment, the patient was discharged from hospital without pulmonary symptoms.

Conclusion: A different fractionation with a lower equivalent dose in 2 Gy fraction compared to literature data showed efficacy in resolving MAO with excellent local control in the first three months of follow-up.

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恶性气道阻塞时气道支架植入术的短程放疗:病例报告与文献综述
背景:近三分之一的肺癌患者会出现继发于肿瘤生长的恶性气道阻塞(MAO),如不及时治疗,预后极差。治疗方案包括支气管镜介入肿瘤剥离、支架置入、支气管内近距离放疗或姑息性放疗:这是一份关于一名 74 岁女性的报告,她有转移性肺腺癌病史,因呼吸困难、咯血和胸痛住院,胸部 X 光和计算机断层扫描发现 MAO。患者接受了总剂量为 13 Gy 的放射治疗,分两次进行,每周一次,每次 6.5 Gy。放疗结束三天后,胸部 X 光片显示右肺完全再扩张,无肺不张。放疗两周后,患者出院,未出现肺部症状:结论:与文献数据相比,2 Gy 分段等效剂量较低的不同分次放疗在治疗 MAO 方面效果显著,在最初三个月的随访中,局部控制良好。
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