Jumpei Kashima1, Yusuke Okuma1, Hiroto Murata2, Kageaki Watanabe1, Yukio Hosomi1, Tsunekazu Hishima3. 1. Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. 2. Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi City, Japan. 3. Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Abstract
BACKGROUND: Because of the rarity of thymic epithelial tumors (TETs), there is no treatment for managing unresectable tumors that is supported by a high level of evidence. We present here the clinical outcomes of concurrent or sequential chemoradiotherapy for patients with unresectable TETs. METHODS: We collated records for 215 patients with TETs who were treated at our institution and focused on the 20 patients who underwent chemoradiotherapy without curative-intent surgical resection. RESULTS: Six patients with thymoma (4%) and 14 patients with thymic carcinoma (19%) were treated with chemoradiotherapy. Six received concurrent therapy, and platinum-containing regimens were administered to 16 patients. The survival of patients with thymic carcinoma was poorer than that of patients with thymoma [median overall survival (OS), 64.1 and 31.4 months, respectively; P=0.059]. No significant difference in survival was observed between patients treated concurrently and sequentially (48.5 vs. 38.2 months, respectively, P=0.83) or between patients treated with platinum-containing regimens and other regimens (43.5 and 53.8 months, respectively, P=0.25). CONCLUSIONS: Chemoradiotherapy for unresectable TETs can be beneficial, especially when administrated concurrently. Patients for concurrent chemoradiotherapy should be chosen carefully because of its effectiveness and toxicity.
BACKGROUND: Because of the rarity of thymic epithelial tumors (TETs), there is no treatment for managing unresectable tumors that is supported by a high level of evidence. We present here the clinical outcomes of concurrent or sequential chemoradiotherapy for patients with unresectable TETs. METHODS: We collated records for 215 patients with TETs who were treated at our institution and focused on the 20 patients who underwent chemoradiotherapy without curative-intent surgical resection. RESULTS: Six patients with thymoma (4%) and 14 patients with thymic carcinoma (19%) were treated with chemoradiotherapy. Six received concurrent therapy, and platinum-containing regimens were administered to 16 patients. The survival of patients with thymic carcinoma was poorer than that of patients with thymoma [median overall survival (OS), 64.1 and 31.4 months, respectively; P=0.059]. No significant difference in survival was observed between patients treated concurrently and sequentially (48.5 vs. 38.2 months, respectively, P=0.83) or between patients treated with platinum-containing regimens and other regimens (43.5 and 53.8 months, respectively, P=0.25). CONCLUSIONS: Chemoradiotherapy for unresectable TETs can be beneficial, especially when administrated concurrently. Patients for concurrent chemoradiotherapy should be chosen carefully because of its effectiveness and toxicity.
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