Clémence Basse1, Sébastien Thureau2, Suzanna Bota3, Eric Dansin4, Pascal-Alexandre Thomas5, Eric Pichon6, Hervé Lena7, Carole Massabeau8, Christelle Clément-Duchene9, Gilbert Massard10, Virginie Westeel11, Xavier Quantin12, Youssef Oulkhouir13, Serge Danhier14, Delphine Lerouge14, Ronan Tanguy15, François Thillays16, Cécile Le Pechoux17, Bernard Dubray2, Luc Thiberville3, Benjamin Besse18, Nicolas Girard19. 1. Medical Oncology Department, Henri Becquerel Cancer Center, Rouen, France. 2. Department of Radiation Oncology and Medical Physics, Henri Becquerel Cancer Center, Rouen, France. 3. Respiratory Medicine Department, University Hospital, Rouen, France. 4. Respiratory Medicine Department, Oscar Lambret Cancer Center, Lille, France. 5. Thoracic Surgery Department, University Hospital, Marseille, France. 6. Respiratory Medicine Department, University Hospital, Tours, France. 7. Respiratory Medicine Department, University Hospital, Rennes, France. 8. Radiotherapy Department, Claudius Regaud Cancer Institute, Toulouse, France. 9. Medicine Department, Cancer Institute, Nancy, France. 10. Thoracic Surgery Department, University Hospital, Strasbourg, France. 11. Respiratory Medicine Department, University Hospital, Besançon, France. 12. Respiratory Medicine Department, University Hospital, Montpellier, France. 13. Respiratory Medicine Department, University Hospital, Caen, France. 14. Radiotherapy Department, François Baclesse Cancer Center, Caen, France. 15. Radiotherapy Department, Léon Bérard Cancer Center, Lyon, France. 16. Radiotherapy Department, Cancer Center, Nantes, France. 17. Radiation Oncology Department, Institut Gustave Roussy, Villejuif, France. 18. Medical Oncology Department, Institut Gustave Roussy, Villejuif, France. 19. Respiratory Department, Hospices Civils of Lyon, Lyon, France. Electronic address: nicolas.girard2@curie.fr.
Abstract
INTRODUCTION: Thymic epithelial tumors (TETs) are rare intrathoracic malignancies for which surgery represents the mainstay of the treatment. Current practice for postoperative radiotherapy (PORT) is highly variable, and there is a lack of prospective, high level evidence. Réseau Tumeurs Thymiques et Cancer (RYTHMIC) is the nationwide network for TETs in France. Established in 2012, it prospectively collects data on all TET patients, for whom management is discussed at a national multidisciplinary tumor board (MTB). We assessed whether PORT decisions at the MTB were in accordance with RYTHMIC guidelines and ultimately implemented in patients. METHODS: All consecutive patients for whom PORT was discussed at the MTB from 2012 to 2015 were identified from the RYTHMIC prospective database, and a complete review of their medical records was performed. RESULTS: A total of 274 patients, including 243 with thymoma (89%) and 31 with thymic carcinoma (11%), were analyzed. The decision of the MTB was in accordance with guidelines in 221 patients (92%) of the 241 with stage I or III TET. An MTB decision to deliver PORT was made for 117 patients (43%). PORT was ultimately initiated in 101 patients. The most frequent reason for not delivering PORT was excessive (>3 months) delay after surgery. Dose-volume constraints defined by the International Thymic Malignancy Interest Group were followed in all but four patients. CONCLUSION: Our data provide a unique insight into the decision-making process for PORT in TETs, highlighting the need for systematic discussion at an expert MTB, while stressing the value of current available guidelines.
INTRODUCTION: Thymic epithelial tumors (TETs) are rare intrathoracic malignancies for which surgery represents the mainstay of the treatment. Current practice for postoperative radiotherapy (PORT) is highly variable, and there is a lack of prospective, high level evidence. Réseau Tumeurs Thymiques et Cancer (RYTHMIC) is the nationwide network for TETs in France. Established in 2012, it prospectively collects data on all TET patients, for whom management is discussed at a national multidisciplinary tumor board (MTB). We assessed whether PORT decisions at the MTB were in accordance with RYTHMIC guidelines and ultimately implemented in patients. METHODS: All consecutive patients for whom PORT was discussed at the MTB from 2012 to 2015 were identified from the RYTHMIC prospective database, and a complete review of their medical records was performed. RESULTS: A total of 274 patients, including 243 with thymoma (89%) and 31 with thymic carcinoma (11%), were analyzed. The decision of the MTB was in accordance with guidelines in 221 patients (92%) of the 241 with stage I or III TET. An MTB decision to deliver PORT was made for 117 patients (43%). PORT was ultimately initiated in 101 patients. The most frequent reason for not delivering PORT was excessive (>3 months) delay after surgery. Dose-volume constraints defined by the International Thymic Malignancy Interest Group were followed in all but four patients. CONCLUSION: Our data provide a unique insight into the decision-making process for PORT in TETs, highlighting the need for systematic discussion at an expert MTB, while stressing the value of current available guidelines.
Authors: Gabrielle Drevet; Stéphane Collaud; François Tronc; Nicolas Girard; Jean-Michel Maury Journal: Cancer Manag Res Date: 2019-07-22 Impact factor: 3.989
Authors: J Remon; R Bernabé; P Diz; E Felip; J L González-Larriba; M Lázaro; X Mielgo-Rubio; A Sánchez; I Sullivan; B Massutti Journal: Clin Transl Oncol Date: 2022-02-05 Impact factor: 3.405