{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:14:20Z","timestamp":1790835260394,"version":"4.1.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malignant central airway obstruction (MCAO) is a life-threatening complication in thoracic oncology. While external beam radiation therapy (EBRT), stenting, bronchoscopic debulking, and combination approaches are widely used, real-world comparative survival data are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the TriNetX US Collaborative Network (2008-2023), we identified adults with MCAO undergoing EBRT (n\u2009=\u200911\u200a478), stenting (n\u2009=\u200911\u200a478), debulking (n\u2009=\u20097855), or stenting plus EBRT (n\u2009=\u20092985). Patients were 1:1 propensity-matched by demographics, cancer type, Eastern Cooperative Oncology Group (ECOG) status, and dyspnea. Kaplan-Meier and Cox proportional hazards models assessed survival; mortality risk was quantified with hazard ratios (HRs) and odds ratios (ORs) at multiple time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In matched cohorts (n\u2009=\u200911\u200a478), EBRT was associated with longer median survival than stenting (1029 vs 627\u2009days; HR, 0.776; P\u2009&amp;lt; .0001) and debulking (1068 vs 692\u2009days; HR, 0.762; P\u2009&amp;lt; .0001), with no mortality difference (odds ratio [OR], 0.957 and P\u2009=\u2009.097; OR, 0.998 and P\u2009=\u2009.948, respectively). Compared with stent\u2009+\u2009EBRT (n\u2009=\u20092985), EBRT had superior survival (1003 vs 545\u2009days; HR, 0.706; P\u2009&amp;lt; .0001) and lower mortality (OR, 0.659; P\u2009&amp;lt; .0001). Combination therapy offered no advantage over stenting alone and was associated with higher mortality (OR, 1.223; P\u2009=\u2009 .000). Dyspnea independently predicted worse survival (HR, &amp;gt;2.0); age and ECOG were not significant predictors. The advantage of EBRT was greatest early. At 6\u2009months, EBRT showed lower mortality than stenting (17.2% vs 23.5%; HR, 0.652), debulking (16.9% vs 23.0%; HR, 0.636), and stent\u2009+\u2009EBRT (20.2% vs 24.8%; HR, 0.808). One-year survival remained higher for EBRT vs stenting (87.7% vs 85.2%; HR, 0.813) and stent\u2009+\u2009EBRT (86.7% vs 84.1%; HR, 0.825). By 5\u2009years, survival rates converged (eg, EBRT vs stenting: 60.1% vs 60.9%; HR, 0.983), with HRs approaching or exceeding 1 by 10 to 15\u2009years, limiting long-term interpretation due to low event counts. In 7- and 30-day landmark analyses, EBRT showed significantly lower hazards of death vs all other modalities, with the largest relative benefit at 7\u2009days (HR, 0.79-0.84; P\u2009&amp;lt; .001). Median survival remained longest with EBRT across all comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>External beam radiation therapy confers early survival benefits over stenting, debulking, and combined therapy without increasing mortality. It should be considered first-line treatment for MCAO, reserving procedural interventions for patients with acute or complex airway compromise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoaf061","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:02:52Z","timestamp":1769158972000},"page":"614-620","source":"Crossref","is-referenced-by-count":4,"title":["Real-world faceoff: EBRT vs interventions for malignant central airway obstruction"],"prefix":"10.1093","volume":"23","author":[{"given":"Roshen","family":"Mathew","sequence":"first","affiliation":[{"name":"Department of Interventional Pulmonary, West Virginia University Camden Clark Medical Center , Parkersburg, WV,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Meena","sequence":"additional","affiliation":[{"name":"Division of Interventional Pulmonary and Critical Care Medicine, University of Arkansas for 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