Emergency SBRT to trachea and carina for adenoid cystic carcinoma of the trachea with partial airway obstruction.

The article focuses on the use of emergency stereotactic body radiation therapy (SBRT) to treat partial airway obstruction caused by adenoid cystic carcinoma (ACC) of the trachea involving the carina. It presents a case of a 36-year-old man with recurrent ACC and metastatic lung nodules who developed significant airway narrowing and was treated with a non-invasive SBRT regimen of 3000 cGy in 5 fractions using volumetric modulated arc therapy (VMAT). The treatment resulted in rapid symptomatic relief of dyspnea, tumor regression, and improved airway patency, with manageable side effects including transient vocal cord palsy. The report suggests that SBRT can be a viable palliative option for urgent airway obstruction in ACC patients, especially when surgery is not feasible.