Silicone Stents in the Management of Inoperable Tracheobronchial Stenoses – Results (4)

Adjuvant Radiotherapy, Stent Patency, and Patient Survival Over Time
Of the 31 patients, 30 had died at the time of writing with a median survival of 2.5 months. The 20 patients suffering from advanced stages of bronchogenic carcinoma (stage IIIB and IV) (Table 3) also had a median survival of 2.5 months (19 dead and 1 alive at the time of writing) compared with 2.25 months in the remaining 10 malignancies. Of the 20 patients with bronchogenic carcinoma, 8 did not undergo adjuvant radiotherapy (group A) and 12 did (group B). Local tumor recurrence above or below the stent led to recurrent airway obstruction in 6 of 8 patients (75 percent) of group A and in 0/12 of group В (p = 0.001). Median survival was 1 month (range, 1 day to 7 months) in group A and 4 months (2 weeks to 13 months) in group В (p<0.05), but patients in group A had more advanced local disease and 4/8 (50 percent) had metastases, whereas in group В only 2/12 (17 percent) had metastases.

To eliminate disease stage as a confounding factor, a subgroup of ten patients with stage IIIB squamous cell carcinoma, comparable age, and pretreatment performance status who underwent elective laser and stent procedures was analyzed: five were in group A and five were in group B. Four of the five patients in group В underwent small volume-high precision percutaneous radiotherapy, 1192Iridium high-dose rate brachytherapy.

Table 3—Local Tumor Recurrence and Survival in Patients With Bronchogenic Carcinoma (n = 20) and in a Subgroup of Patients With Stage 1ПВ Squamous Cell Carcinoma* (n = 10)

Local Tumor Recurrence Survival, mo
Bronchogenic carcinoma (n = 20) 2.5
Group A 6/8 1
p = 0.001 p<0.05
Group В 0/12 4
Stage IIIB squamous cell carcinoma (n = 10) 5
Group A 4/5 4
p = 0.02 NS
Group В 0/5 6