title: Tracheal cancer: Role of radiation therapy.
abstract: OBJECTIVE
  To assess the results of tracheal cancer patients treatment and factors influencing prognosis.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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%).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Radiation Oncology Department, Centre of Oncology, Krakow, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Hetnał
authors.affiliation: Breast and Thoracic Cancer Unit, Centre of Oncology, Krakow, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Kielaszek-Ćmiel
authors.affiliation: Breast and Thoracic Cancer Unit, Centre of Oncology, Krakow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Wolanin
authors.affiliation: Breast and Thoracic Cancer Unit, Centre of Oncology, Krakow, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Korzeniowski
authors.affiliation: Radiation Oncology Department, Centre of Oncology, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Brandys
authors.affiliation: Brain, Head and Neck Cancer Unit Centre of Oncology, Krakow, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Małecki
authors.affiliation: Breast and Thoracic Cancer Unit, Centre of Oncology, Krakow, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Sas-Korczyńska
authors.affiliation: Breast and Thoracic Cancer Unit, Centre of Oncology, Krakow, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Chłosta
authors.affiliation: Breast and Thoracic Cancer Unit, Centre of Oncology, Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kokoszka
keywords: Prognostic factors; Radiotherapy; Staging; Tracheal cancer