title: Endotracheal brachytherapy alone: An effective palliative treatment for tracheal tumors.
abstract: BACKGROUND
  Tracheal tumors are rare. They are usually unresectable and treated primarily with external beam radiation. The use of palliative endotracheal brachytherapy (ETBT) alone in treating patients with tracheal tumors has not been reported.
  
  
  METHODS
  Using a prospective database, demographic, treatment, and outcome data of patients with tracheal tumors treated palliatively with ETBT from 2006 to 2014 were analyzed. Tumor and symptom responses were evaluated based on response evaluation criteria in solid tumors criteria. Survival, in-field disease control, symptom response, and duration of symptom responses were evaluated using descriptive analyses.
  
  
  RESULTS
  Sixteen ETBT (median, 2) treatments were delivered to 8 patients. Median age was 63.4 years old. Common symptoms were hemoptysis, cough, and dyspnea. Tracheal lengths of 3.5-11 cm were treated with 5-7 Gy/fraction, using 1-3 fractions. The mean overall survival was 5 months and symptom-free survival was 6.8 months, respectively. After ETBT, 88% of patients experienced symptomatic improvement (hemoptysis [n = 3/3], cough [n = 6/7], and dyspnea [n = 4/4]). One patient developed Grade 1 stenosis that did not require intervention.
  
  
  CONCLUSIONS
  This is among the largest series of tracheal tumors treated palliatively with ETBT alone. ETBT provided effective palliation with symptom improvement and minimal toxicity.
authors: Department of Oncology, Division of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario, Canada. Electronic address: nhu.t.a.nguyen@gmail.com.
authors: Nhu-Tram A
authors: NT
authors: Nguyen
authors: Department of Oncology, Division of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario, Canada.
authors: Emilia
authors: E
authors: Timotin
authors: Department of Oncology, Division of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario, Canada.
authors: Robert
authors: R
authors: Hunter
authors: Department of Oncology, Division of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario, Canada.
authors: Crystal
authors: C
authors: Hann
authors: Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors: Serge
authors: S
authors: Puksa
authors: Department of Oncology, Division of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario, Canada.
authors: Ranjan K
authors: RK
authors: Sur
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D003371:Cough / Q000209:etiology; D019583:Dose Fractionation, Radiation; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D015996:Survival Rate; D014134:Tracheal Neoplasms / Q000150:complications / Q000532:radiotherapy*; D016896:Treatment Outcome
keywords: Endotracheal brachytherapy; High-dose rate; Palliation; Tracheal tumors