A Review of the Place and Role of Radiotherapy in Thymoma

Lombe, Dorothy; Jeremić, Branislav

doi:10.1016/j.cllc.2015.05.003

Cited by 17 publications

(13 citation statements)

References 37 publications

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“…Our data is consistent with the outcomes of previous studies that reoperation might result in better survival than non-surgery treatment, especially when complete resection was possible [3,4,[6][7][8]10,12,[16][17][18][19][20][21]. A meta- advanced stage (III/IV) thymoma or incomplete resection [4,8,[28][29][30][31][32], theoretically, adjuvant treatment may also improve the outcomes of recurrent thymoma. The good outcomes of the surgery group in our study may suggest that adjuvant treatment might improve the outcomes of patients with recurrence because of the high rate of patients receiving adjuvant treatment.…”

Section: Discussionsupporting

confidence: 81%

Long-Term Outcomes of Recurrent Thymoma

Cai¹,

Feng²,

Hui³

et al. 2016

J Pulm Respir Med

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Section: Discussionsupporting

confidence: 81%

Long-Term Outcomes of Recurrent Thymoma

Cai¹,

Feng²,

Hui³

et al. 2016

J Pulm Respir Med

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“…The patients treated with surgical resection alone and those treated with postoperative radiotherapy showed significant, though conflicting, results [21], which may be due to heterogeneous subject populations and therapeutic regimens. Our results suggest that postoperative radiotherapy reduced the recurrence rate and prolonged DFS after complete resection of thymoma.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of 307 patients after complete thymoma resection

Yuan

Gao

et al. 2017

Chin J Cancer

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BackgroundThymoma is an uncommon tumor without a widely accepted standard care to date. We aimed to investigate the clinicopathologic variables of patients with thymoma and identify possible predictors of survival and recurrence after initial resection.MethodsWe retrospectively selected 307 patients with thymoma who underwent complete resection at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (Beijing, China) between January 2003 and December 2014. The associations of patients’ clinical characteristics with prognosis were estimated using Cox regression and Kaplan–Meier survival analyses.ResultsDuring follow-up (median, 86 months; range, 24–160 months), the 5- and 10-year disease-free survival (DFS) rates were 84.0% and 73.0%, respectively, and the 5- and 10-year overall survival (OS) rates were 91.0% and 74.0%, respectively. Masaoka stage (P < 0.001), World Health Organization (WHO) histological classification (P < 0.001), and postoperative radiotherapy after initial resection (P = 0.006) were associated with recurrence (52/307, 16.9%). Multivariate analysis revealed that, after initial resection, WHO histological classification and Masaoka stage were independent predictors of DFS and OS. The pleura (25/52, 48.0%) were the most common site of recurrence, and locoregional recurrence (41/52, 79.0%) was the most common recurrence pattern. The recurrence pattern was an independent predictor of post-recurrence survival. Patients with recurrent thymoma who underwent repeated resection had increased post-recurrence survival rates compared with those who underwent therapies other than surgery (P = 0.017).ConclusionsMasaoka stage and WHO histological classification were independent prognostic factors of thymoma after initial complete resection. The recurrence pattern was an independent predictor of post-recurrence survival. Locoregional recurrence and repeated resection of the recurrent tumor were associated with favorable prognosis.

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“…Complete surgical en bloc resection of thymoma is the mainstay of treatment and the completeness of resection a strong prognostic factor in humans, and most likely also in dogs and cats . However, complete excision is not possible in a proportion of cases in humans, dogs, cats and rabbits, and for these patients radiotherapy can be used as neoadjunctive, post‐operative adjunctive or sole therapy . As resectability is closely related to prognosis, a strategy using neoadjuvant treatment with radiotherapy may result in an optimization of resectability of invasive or very large thymomas due to facilitated surgical manipulation after tumour volume reduction and/or improved patient's general condition .…”

Section: Introductionmentioning

confidence: 99%

Dosimetric benefit of adaptive radiotherapy in the neoadjuvant management of canine and feline thymoma—An exploratory case series

Bley

Meier

Schneider

2018

Vet Comparative Oncology

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While surgery is the treatment of choice for thymomas, complete excision is not possible in a significant proportion of cases. For these patients, radiotherapy can be used as neoadjunctive, post-operative adjunctive or sole therapy. During radiotherapy, rapid biological clearance of tumour cells is often observed, requiring adaptation of the treatment plan. Adaptive radiation therapy (RT) is a dynamic process, whereby the treatment plan is altered throughout the treatment course due to changes in morphologic, functional or positioning changes. With the hypothesis, that individually adapted replanning will massively reduce the dose to organs at risk (OAR) in a fast-changing environment such as a rapidly responding thymoma, the dosimetric impact of adaptive treatment planning in 5 patients with large thymoma was measured. In all patients rapid tumour-shrinkage of the gross tumour volume was observed after 1 week of therapy, with a mean shrinkage of 31.0% ± 15.2%, or a tumour regression of 5.2% per day. In consequence, there was a considerable change in position of organs such as heart and lung, both of them moving cranially into the high dose area upon tumour regression. After mid-therapy replanning, the dose to OAR was significantly reduced, with -18.2% in the mean heart dose and -27.9% in the V20 lung dose. Adaptive planning led to a significantly reduced radiation dose and hence protection of OAR for these patients. It can be concluded that adaptive replanning should be considered for canine and feline thymoma patients receiving fractionated RT.

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A Review of the Place and Role of Radiotherapy in Thymoma

Cited by 17 publications

References 37 publications

Long-Term Outcomes of Recurrent Thymoma

Long-Term Outcomes of Recurrent Thymoma

Long-term outcomes of 307 patients after complete thymoma resection

Dosimetric benefit of adaptive radiotherapy in the neoadjuvant management of canine and feline thymoma—An exploratory case series

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