Abstract
PURPOSE
Granulation tissue-induced tracheal stenosis (mainly secondary to intubation or lung
transplantation) is one of the most common etiologies of benign airway obstructions.
Recurrence rates after standard treatment options (surgical resection and/or endobronchial
interventions) can inadvertently worsen the stricture through the stimulation of more
granulation tissue generation (via increased fibroblast activity and roliferation).
Low-dose radiotherapy could be a promising tool to prevent granulation tissue formation
after surgery and/or endobronchial interventions regarding its established role in
the treatment of keloids or hypertrophic scars, two benign diseases with similar a
pathophysiology to tracheal stenosis. This study reviews case reports and small series
that used endobronchial brachytherapy (EBBT) or external beam radiotherapy (EBRT)
for the management of refractory granulation tissue-induced tracheal stenosis after
surgery and/or endobronchial interventions.
METHODS AND MATERIALS
Case reports and series (published up to October 2022) that reported outcomes of patients
with recurrent granulation tissue-induced tracheal stenosis (after surgery and/or
endobronchial interventions) treated by EBBT or EBRT (in definitive or prophylactic
settings) were eligible.
RESULTS
Sixteen studies (EBBT: nine studies including 69 patients, EBRT: seven studies including
32 patients) were reviewed. The pooled success rate across all studies was 74% and
97% for EBBT and EBRT, respectively.
CONCLUSIONS
Radiation therapy appears to be effective in the management of selected patients with
recurrent/refractory tracheal stenosis. Response to this treatment is usually good,
but further studies with a larger number of patients and long-term followup are necessary
to determine the optimal technique, dose, and timing of radiation therapy, late complications,
the durability of response, and criteria for patient selection.
Keywords
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Article info
Publication history
Published online: March 14, 2023
Accepted:
January 15,
2023
Received in revised form:
January 9,
2023
Received:
October 20,
2022
Publication stage
In Press Corrected ProofFootnotes
Disclosures: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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© 2023 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
