Adjuvant Radiotherapy for Stages II and III Resected Thymoma

Yan, Jinchun; Q, Liu; Moseley, Jessica N.; Baik, Christina S.; Chow, Laura Q.; Goulart, Bernardo; Zlotnick, David M.; Papanicolau-Sengos, Antoni; Gallaher, Ian S.; Knopp, Joy M.; Zeng, Jing; Patel, Shilpen

doi:10.1097/coc.0000000000000044

Cited by 12 publications

(13 citation statements)

References 18 publications

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“…Five of the eight R1 patients relapsed within 5 years; three of these patients had distant relapses (two lung and one bone) and two had local recurrences (pleural metastases). These results are completely in line with previously published data 15. On the other hand, histology did not affect the prognosis, although this finding may be due to the small sample size.…”

Section: Discussionsupporting

confidence: 93%

Adjuvant treatment in patients at high risk of recurrence of thymoma: efficacy and safety of a three-dimensional conformal radiation therapy regimen

Perri

Pisconti

Conson

et al. 2015

OTT

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BackgroundThe clinical benefits of postoperative radiation therapy (PORT) for patients with thymoma are still controversial. In the absence of defined guidelines, prognostic factors such as stage, status of surgical margins, and histology are often considered to guide the choice of adjuvant treatment (radiotherapy and/or chemotherapy). In this study, we describe our single-institution experience of three-dimensional conformal PORT administered as adjuvant treatment to patients with thymoma.MethodsTwenty-two consecutive thymoma patients (eleven male and eleven female) with a median age of 52 years and treated at our institution by PORT were analyzed. The patients were considered at high risk of recurrence, having at least one of the following features: stage IIB or III, involved resection margins, or thymic carcinoma histology. Three-dimensional conformal PORT with a median total dose on clinical target volume of 50 (range 44–60) Gy was delivered to the tumor bed by 6–20 MV X-ray of the linear accelerator. Follow-up after radiotherapy was done by computed tomography scan every 6 months for 2 years and yearly thereafter.ResultsTwo of the 22 patients developed local recurrence and four developed distant metastases. Median overall survival was 100 months, and the 3-year and 5-year survival rates were 83% and 74%, respectively. Median disease-free survival was 90 months, and the 5-year recurrence rate was 32%. On univariate analysis, pathologic stage III and presence of positive surgical margins had a significant impact on patient prognosis. Radiation toxicity was mild in most patients and no severe toxicity was registered.ConclusionAdjuvant radiotherapy achieved good local control and showed an acceptable toxicity profile in patients with high-risk thymoma.

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Section: Discussionsupporting

confidence: 93%

Adjuvant treatment in patients at high risk of recurrence of thymoma: efficacy and safety of a three-dimensional conformal radiation therapy regimen

Perri

Pisconti

Conson

et al. 2015

OTT

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“…20,23 When the risk of disease is high (eg, close margins/ positive margins or advanced stage disease representing invasion, where tumor cells can be present in surrounding tissue), PORT had superior outcomes because it eliminated this risk. 32,33,35 Another ingredient to this is the histological subtype, which determines the clinical course that the disease takes. 13,26,29 The mode of delivery of RT is important with more conformal and precise techniques recommended.…”

Section: Resultsmentioning

confidence: 99%

A Review of the Place and Role of Radiotherapy in Thymoma

Lombe

Jeremić

2015

Clinical Lung Cancer

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“…Previously, it is controversial whether thymoma patients undergoing surgery should receive postoperative adjuvant radiation. [ 18 19 20 ] Adjuvant radiotherapy after complete surgical excision has previously been regarded as the standard of care. However, majority of experts questioned whether adjuvant radiation after complete resection was worth it in recent years.…”

Section: Discussionmentioning

confidence: 99%

Value of Adjuvant Radiotherapy for Thymoma with Myasthenia Gravis after Extended Thymectomy

Yun

et al. 2018

Chinese Medical Journal

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Background:The co-existence of myasthenia gravis (MG) and thymoma makes the surgical treatment more complicated and adjuvant radiation more controversial. The aim of this study was to investigate adjuvant radiotherapy for thymoma with MG after extended thymectomy.Methods:A total of 181 patients with both MG and thymoma were recruited between 2003 and 2014 at Tongren Hospital, China. Among all the patients, 157 patients received radiation therapy after surgery (Group A); whereas the other 24 patients did not receive radiation therapy (Group B). According to the time that patients started mediastinal radiation therapy, we subdivided the 157 patients in Group A into subgroups (1-month subgroup, n = 98; 2-month subgroup, n = 7; and 3-month subgroup, n = 52). We then compared the effect of the mediastinal radiation therapy across these different groups using the survival rate, the rate of postoperative myasthenic crisis, and the complete stable remission (CSR) rate as the primary endpoints.Results:There was a significant difference in the occurrence of postoperative myasthenic crisis between 1-month subgroup and Group B (χ2 = 4.631, P = 0.031). The rates of reaching CSR were 32.6% in 1-month subgroup, 25% in 3-month subgroup, and 22.7% in Group B, respectively. The overall survival rates of 1-month subgroup, 3-month subgroup, and Group B were 88.8%, 83.3%, and 77.3%, respectively. Analysis on the Kaplan-Meier survival curves demonstrated that within 8 years after surgery, there was no significant difference in aspects of overall survival and disease-free survival between 1-month subgroup and Group B, and between 3-month subgroup and Group B; over 8 years after surgery, the disease-free survival rates in 1-month subgroup, 3-month subgroup and Group B were 79.4%, 70.6%, and 55.3%, respectively.Conclusions:Adjuvant radiation within 1 month after extended thymectomy may be helpful in controlling postoperative MG, such as decreasing the possibility of postoperative myasthenic crisis, and raising cumulative probabilities of reaching CSR.

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Adjuvant Radiotherapy for Stages II and III Resected Thymoma

Cited by 12 publications

References 18 publications

Adjuvant treatment in patients at high risk of recurrence of thymoma: efficacy and safety of a three-dimensional conformal radiation therapy regimen

Adjuvant treatment in patients at high risk of recurrence of thymoma: efficacy and safety of a three-dimensional conformal radiation therapy regimen

A Review of the Place and Role of Radiotherapy in Thymoma

Value of Adjuvant Radiotherapy for Thymoma with Myasthenia Gravis after Extended Thymectomy

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