- 期刊
Management and Outcome of Tracheal Malignancy: Experience in a University-Affiliated Hospital
氣管腫瘤的處置與預後－長庚醫院的經驗分享
摘要
前言：氣管腫瘤發生的機會罕見，大多數氣管腫瘤都是惡性的，其中超過二分之一為鱗狀上皮癌，原發性的氣管腫瘤則大多數為腺樣囊狀癌（adenoid cystic carcinoma），氣管腫瘤相對其他肺部腫瘤發生的機率低，因而這個回溯性研究我們研究長庚醫院氣管腫瘤患者的診斷，治療處置，併發症和預後的分析。方法：這個研究收集了資料庫自西元2002年6月至西元2013年12月，45位氣管腫瘤病人，分析病人基本資料，病理切片結果，原發性和續發性的氣管腫瘤，臨床的症狀，治療，併發症和預後的資料，做變數分析。結果：收集到的氣管腫瘤資料，23位為原發性（51%），22位為續發性（49%），原發性的腫瘤中以腺樣囊狀癌為大宗（52%），第二位為鱗狀上皮癌。續發性氣管腫瘤患者占多數為鱗狀上皮癌13位（59%），其次為腺癌。臨床上最常表現出來的症狀為咳嗽和喘。共計有19位病患（42%）接受手術治療，23位（51%）接受放射線治療，16位（35%）接受化學治療。總計有16位病患接受單一方式的治療，17位病患接受兩種以上的方式治療，4位病患接受3種以上的治療。平均存活日在原發性氣管腫瘤是2674天，續發性氣管腫瘤是125天，在原發性氣管腫瘤中，腺樣囊狀癌的平均存活日是3773日。結論：原發性氣管腫瘤中，腺樣囊狀癌不論經由何種治療方式，有比較好的預後，而轉移到氣管的續發性腫瘤平均而言有比較差的預後。這篇研究顯示經由病患的症狀和影像學，若能早期診斷出氣管腫瘤，進而做出適當的處置，氣管腫瘤患者可以有較好的預後和生活品質。
並列摘要
Background: Tracheal tumors are rare. The majority of the tumors in adults are malignant, with about 1/2 to 2/3 being squamous cell carcinomas (SCC). Adenoid cystic carcinomas (ACC) were the second most common of all and the most common for primary tracheal malignancy. Because of the rarity of tracheal tumors and the lack of clarity about their clinical outcome, we retrieved patient information from our cancer registration center and database for analysis. Objective: To investigate the clinical manifestations, management and outcome of tracheal tumors. Patients and Methods: Using tumor location in the trachea as the search term, data on 45 patients with tracheal malignant tumors from July 2002 to December 2013 were retrieved from the database of our cancer center. Histology, primary or metastatic, initial clinical manifestations, therapy and outcome were analyzed. Results: Twenty-three patients (51%) had a primary tumor and 22 (49%) had a metastatic tumor. Among the primary tumors, 12 (52%) were ACC, 6 (26%) were SCC, and 3 (13%) were mucoepidermoid carcinoma. Of those patients with metastatic tumors, 13 (59%) had SCC, and 3 (13%) had adenocarcinoma. The most common manifestation was cough and the second most common was dyspnea. Nineteen patients (42%) underwent surgery, 23 (51%) radiation therapy, and 16 (35%) chemotherapy. Sixteen patients received a single modality of therapy, 17 patients, 2 modalities, and 14 patients, 3 modalities. The median survival of patients with primary tracheal tumor was 2674 days, and for those with metastatic cancer, 125 days. Among the primary tumors, the median survival of those with ACC was 3773 days. Conclusions: Primary ACC patients had a better outcome than those with the other tracheal malignancies, and patients with metastatic tracheal malignancy had a poor survival outcome.