Radiation therapy of invasive thymoma

Nonsurgical management of malignant thymoma

“…The overall local control rate was 67%, with a 5-year survival of 57%, indicating that postoperative radiation is an effective therapeutic modality in the control of Stage III thymoma. Arakawa et al 35 ) reported similar data in 30 patients with invasive thymoma irradiated with 30 -58 Gy, resulting in an overall local control of 73%. In a comparable study, Jackson and Ball 36 achieved a 5-year survival rate of 73% and a 10-year survival rate of 44% after incomplete resection or biopsy with application of local postoperative radiation in 28 patients with invasive thymoma.…”

“…The data published so far, however, suggest promising clinical potential for adjuvant radiotherapy with extended radiation fields after resection of more advanced lesions as well as for local control of subtotally resected tumors. 17,35,[37][38][39] It is noteworthy that survival for patients who received adjuvant irradiation did not appear to correlate with tumor stage. 27 .…”

“…In the absence of randomized trials to solve this problem, the predominance of positive trials published suggests radiation as the treatment of choice after resection outside of clinical studies. [33][34][35][36][37][38][39] The application of chemotherapy has been studied both with single agents and with combination regimens (Tables 2, 3). Although cisplatinum and steroids have been the most extensively investigated agents, no direct comparison between monochemotherapy and combination regimens has been performed.…”

Thymoma: Update for the New Millenium

“…In a study by Urgesi and colleagues, 33 patients with completely resected stage III disease given postoperative radiotherapy showed no infield recurrences (although three of the patients did develop out-of-field recurrences) [35]. Similarly, Arakawa and colleagues reported that in 15 patients with invasive thymoma (stage III and IV) who received postoperative radiotherapy (30-58.7 Gy in 1.8-2.0 Gy fractions) there were only two tumor recurrences and all of the patients were alive at the time of last follow-up [36]. In addition, Nakahara and colleagues reported a 95% 15-year survival rate in 35 patients who were given postoperative radiotherapy for completely resected stage III thymoma [37].…”

“…Definitive radiation therapy alone as the primary treatment has been advocated in non-surgical candidates or patients with unresectable advanced (stages III and IV) disease. Arakawa and associates reported 7 out of the 12 patients who presented with unresectable tumors and were treated with primary radiotherapy only were alive for observation periods from 1 year 8 months to 5 years and 1 month [36]. Ciernik and associates reported similar prognoses when comparing radiation alone to tumor debulking and radiation therapy in 31 stage III and IV patients [43].…”