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INTRODUCTION: Lung cancer is the most common cause of cancer death in both men and women worldwide. Most patients will have advanced disease at the time of diagnosis. This results in many patients being referred initially to oncology and radiation oncologists without ever being a surgical candidate. We report on four patients over three years who developed major central airway complications following treatment with chemotherapy and radiation, with two patients receiving anti-angiogenic chemotherapeutic drugs. CASE REPORT: Four cases are included in this case series of patients that developed post treatment central bronchopleural fistula after treatment for a central airway tumor. There were two men and two females, mean age of 65 years. Different techniques, including stenting and the use of extracorporeal membrane oxygenation were required for treatment and stabilization of the airway. There was a 75% mortality in this series. DISCUSSION: Airway complications resulting in large airway defects are life threatening and difficult to manage. Treatment of these central airway tumors can result in catastrophic complications. CONCLUSION The cases presented report a complication of concurrent chemotherapy and radiation treatment, with concern for use of vascular endothelial growth factor (VEGF) inhibitors on advanced central and upper airway malignancy.
