Progress of study on effect of postoperative adjuvant radiotherapy for patients with thymoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MA Jianxing , FENG Haiming , JING Tao ,  LI Bin , WANG Cheng , ZHANG Jianhua

Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou, 730030, P.R.China;

Corresponding author：

LI Bin, Email: dr.leebin@qq.com

Keywords：

Thymic epithelial tumor; adjuvant radiotherapy; surgery; the progress of study

DOI：

10.7507/1007-4848.201605011

Video：

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Thymoma is aggressive and persistent, but does not belong to malignant tumors. In treatments, their optimal treatment protocols still need to be studied and how about the role and the place of use of postoperative radiotherapy is not clear. Some retrospective studies indicate a direction: for the first stage of thymoma, it is adequately treated with complete resection alone. For the second stage of the thymoma, postoperative radiotherapy needs further indications. For the third and fourth stages of thymoma, postoperative radiotherapy plays an important role. A research shows that the radiation dose at 50 Gy is suitable for microscopic tumors, and higher dose of radiation is suitable for macroscopic tumors. With the development of radiotherapy technology, its application scope becomes larger and larger. What kind of the role and the place for radiotherapy in the treatment of thymoma and what is the optimal management of thymoma need to be treated prudently.

Citation： MA Jianxing, FENG Haiming, JING Tao, LI Bin, WANG Cheng, ZHANG Jianhua. Progress of study on effect of postoperative adjuvant radiotherapy for patients with thymoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(6): 480-484. doi: 10.7507/1007-4848.201605011 Copy

1.	Tomaszek S, Wigle DA, Keshavjee S, et al. Thymomas: review of current clinical practice. Ann Thorac Surg, 2009, 87(6): 1973-1980.
2.	Abildgaard J, Pappot H, Petersen PM, at al. Lack of uniformity in the treatment of thymomas. Ugesk Laeger, 2013, 174 (50): 3164-3169.
3.	Iwasaki T, Nakagawa K, Yasukawa M, et al. Ectopic cervico-mediastinal thymoma confirmed by flow cytometric analysis of tumor-derived lymphocytes. Jpn J Thorac Cardiovasc Surg, 2006, 54(1): 35-39.
4.	Thymoma A. Reports on thymoma findings from University of Heidelberg, Institute of Pathology provide new insights. Science Letter, 2010.
5.	Harnath T, Marx A, Ströbel P, et al. Thymoma –a clinico-pathological long-term study with emphasis on histology and adjuvant radiotherapy dose. J Thorac Oncol, 2012, 7(12): 1867-1871.
6.	Zhu G, He S, Fu X, et al. Radiotherapy and prognostic factors for thymoma: a retrospective study of 175 patients. Int J Radiat Oncol Biol Phys, 2004, 60: 1113-1119.
7.	Eng TY, Thomas CR Jr. Radiation therapy in the management of thymic tumors. Semin Thorac Cardiovasc Surg, 2005, 17(1): 32-40.
8.	Port JL, Ginsberg RJ. Surgery for thymoma. Chest Surg Clin N Am, 2001, 11 (2): 421-437.
9.	付浩, 中国胸腺瘤协作组全体成员, Daniel Gomez, 等. 胸腺瘤放疗的相关定义和报告指南. 中国肺癌杂志, 2014, 17(2): 110-115.
10.	Perri F, Pisconti S, Conson M, et al. Adjuvant treatment in patients at high risk of recurrence of thymoma: efficacy and safety of a three-dimensional conformal radiation therapy regimen. Onco Targets Ther, 2015, 8: 1345-9.
11.	D'Andrea MA, Reddy RG. Management of metastatic malignant thymoma with advanced radiation and chemotherapy techniques: report of a rare case. World J Surg Oncol, 2015, 13 : 77.
12.	Lim YJ, Kim HJ, Wu HG, et al. Role of postoperative radiotherapy in nonlocalized thymoma: propensity-matched analysis of surveillance, epidemiology, and end results database. J Thorac Oncol, 2015, 10(9): 1357-1363.
13.	Omasa M, Date H, Sozu T, et al. Postoperative radiotherapy is effective for thymic carcinoma but not for thymoma in stage Ⅱ and Ⅲ thymic epithelial tumors: the Japanese Association for Research on the Thymus Database Study. Cancer, 2015, 121(7): 1008-1016.
14.	Yan J, Liu Q, Moseley JN, et al. Adjuvant radiotherapy for stages Ⅱ and Ⅲ resected thymoma: a single-institutional experience. Am J Clin Oncol, 2016, 39(3): 223-227.
15.	Fan C, Feng Q, Chen Y, et al. Postoperative radiotherapy for completely resected Masaoka stage Ⅲ thymoma: a retrospective study of 65 cases from a single institution.Radiat Oncol, 2013, 8: 199.
16.	Weksler B, Shende M, Nason KS, et al. The role of adjuvant radiation therapy for resected stage Ⅲ thymoma: a population-based study. Ann Thorac Surg, 2012, 93(6): 1822-1828.
17.	Rena O, Mineo TC, Casadio C. Multimodal treatment for stage IVA thymoma: a proposable strategy. Lung Cancer, 2012 , 76(1): 89-92.
18.	Berman AT, Litzky L, Livolsi V, et al. Adjuvant radiotherapy for completely resected stage 2 thymoma. Cancer, 2011, 117(15): 3502-3508.
19.	Fernandes AT, Shinohara ET, Guo M, et al. The role of radiation therapy in malignant thymoma: a surveillance, epidemiology, and end results database analysis. J Thorac Oncol, 2010, 5(9): 1454-1460.
20.	Ma J, Sun X, Huang L, et al. Postoperative radiotherapy and tumor recurrence after complete resection of stage Ⅱ/Ⅲ thymic tumor: a meta-analysis of cohort studies. Onco Targets Ther, 2016, 9: 4517-4526.
21.	Zhou D, Deng XF, Liu QX, et al. The effectiveness of postoperative radiotherapy in patients with completely resected thymoma: a meta-analysis. Ann Thorac Surg, 2016, 101(1): 305-310.
22.	徐凌, 沈盛萍, 艾星浩, 等. 胸腺瘤完整切除术后辅助放疗不提高总体生存率. 肿瘤, 2014, 34(1): 67-71.
23.	龚虹云, 宋启斌, 姚颐, 等. 胸腺瘤完整切除术后辅助放疗效果系统评价. 肿瘤防治研究, 2011, 38(11): 1292-1295.
24.	Yirmibeşoğlu Erkal E, Akgül AG, Halis H, et al. Thymic epithelial tumors: analysis of prognostic factors with emphasis on the role of adjuvant radiation therapy. Oncol Res Treat, 2014, 37(7-8): 396-399.
25.	Kondo K. Therapy for thymic epithelial tumors. Gen Thorac Cardiovasc Surg,2014 , 62(8):468-474.
26.	Forquer JA, Rong N, Fakiris AJ, et al. Postoperative radiotherapy after surgical resection of thymoma: differing roles in localized and regional disease. Int J Radiat Oncol Biol Phys, 2010, 76(2): 440-445.
27.	Rimner A. Postoperative radiotherapy: not all thymic malignancies are created equal. Cancer, 2015, 121(7): 972-974.
28.	付浩, 中国胸腺瘤协作组全体成员, Frank Detterbeck. 胸腺肿瘤预后因素的现状. 中国肺癌杂志, 2014, 17(2): 130-132.Ref.
29.	Song Z, Jin X, Zhang Y. Treatment and prognosis of type B2 thymoma. World J Surg Oncol, 2014, 12: 291.

1. Tomaszek S, Wigle DA, Keshavjee S, et al. Thymomas: review of current clinical practice. Ann Thorac Surg, 2009, 87(6): 1973-1980.
2. Abildgaard J, Pappot H, Petersen PM, at al. Lack of uniformity in the treatment of thymomas. Ugesk Laeger, 2013, 174 (50): 3164-3169.
3. Iwasaki T, Nakagawa K, Yasukawa M, et al. Ectopic cervico-mediastinal thymoma confirmed by flow cytometric analysis of tumor-derived lymphocytes. Jpn J Thorac Cardiovasc Surg, 2006, 54(1): 35-39.
4. Thymoma A. Reports on thymoma findings from University of Heidelberg, Institute of Pathology provide new insights. Science Letter, 2010.
5. Harnath T, Marx A, Ströbel P, et al. Thymoma –a clinico-pathological long-term study with emphasis on histology and adjuvant radiotherapy dose. J Thorac Oncol, 2012, 7(12): 1867-1871.
6. Zhu G, He S, Fu X, et al. Radiotherapy and prognostic factors for thymoma: a retrospective study of 175 patients. Int J Radiat Oncol Biol Phys, 2004, 60: 1113-1119.
7. Eng TY, Thomas CR Jr. Radiation therapy in the management of thymic tumors. Semin Thorac Cardiovasc Surg, 2005, 17(1): 32-40.
8. Port JL, Ginsberg RJ. Surgery for thymoma. Chest Surg Clin N Am, 2001, 11 (2): 421-437.
9. 付浩, 中国胸腺瘤协作组全体成员, Daniel Gomez, 等. 胸腺瘤放疗的相关定义和报告指南. 中国肺癌杂志, 2014, 17(2): 110-115.
10. Perri F, Pisconti S, Conson M, et al. Adjuvant treatment in patients at high risk of recurrence of thymoma: efficacy and safety of a three-dimensional conformal radiation therapy regimen. Onco Targets Ther, 2015, 8: 1345-9.
11. D'Andrea MA, Reddy RG. Management of metastatic malignant thymoma with advanced radiation and chemotherapy techniques: report of a rare case. World J Surg Oncol, 2015, 13 : 77.
12. Lim YJ, Kim HJ, Wu HG, et al. Role of postoperative radiotherapy in nonlocalized thymoma: propensity-matched analysis of surveillance, epidemiology, and end results database. J Thorac Oncol, 2015, 10(9): 1357-1363.
13. Omasa M, Date H, Sozu T, et al. Postoperative radiotherapy is effective for thymic carcinoma but not for thymoma in stage Ⅱ and Ⅲ thymic epithelial tumors: the Japanese Association for Research on the Thymus Database Study. Cancer, 2015, 121(7): 1008-1016.
14. Yan J, Liu Q, Moseley JN, et al. Adjuvant radiotherapy for stages Ⅱ and Ⅲ resected thymoma: a single-institutional experience. Am J Clin Oncol, 2016, 39(3): 223-227.
15. Fan C, Feng Q, Chen Y, et al. Postoperative radiotherapy for completely resected Masaoka stage Ⅲ thymoma: a retrospective study of 65 cases from a single institution.Radiat Oncol, 2013, 8: 199.
16. Weksler B, Shende M, Nason KS, et al. The role of adjuvant radiation therapy for resected stage Ⅲ thymoma: a population-based study. Ann Thorac Surg, 2012, 93(6): 1822-1828.
17. Rena O, Mineo TC, Casadio C. Multimodal treatment for stage IVA thymoma: a proposable strategy. Lung Cancer, 2012 , 76(1): 89-92.
18. Berman AT, Litzky L, Livolsi V, et al. Adjuvant radiotherapy for completely resected stage 2 thymoma. Cancer, 2011, 117(15): 3502-3508.
19. Fernandes AT, Shinohara ET, Guo M, et al. The role of radiation therapy in malignant thymoma: a surveillance, epidemiology, and end results database analysis. J Thorac Oncol, 2010, 5(9): 1454-1460.
20. Ma J, Sun X, Huang L, et al. Postoperative radiotherapy and tumor recurrence after complete resection of stage Ⅱ/Ⅲ thymic tumor: a meta-analysis of cohort studies. Onco Targets Ther, 2016, 9: 4517-4526.
21. Zhou D, Deng XF, Liu QX, et al. The effectiveness of postoperative radiotherapy in patients with completely resected thymoma: a meta-analysis. Ann Thorac Surg, 2016, 101(1): 305-310.
22. 徐凌, 沈盛萍, 艾星浩, 等. 胸腺瘤完整切除术后辅助放疗不提高总体生存率. 肿瘤, 2014, 34(1): 67-71.
23. 龚虹云, 宋启斌, 姚颐, 等. 胸腺瘤完整切除术后辅助放疗效果系统评价. 肿瘤防治研究, 2011, 38(11): 1292-1295.
24. Yirmibeşoğlu Erkal E, Akgül AG, Halis H, et al. Thymic epithelial tumors: analysis of prognostic factors with emphasis on the role of adjuvant radiation therapy. Oncol Res Treat, 2014, 37(7-8): 396-399.
25. Kondo K. Therapy for thymic epithelial tumors. Gen Thorac Cardiovasc Surg,2014 , 62(8):468-474.
26. Forquer JA, Rong N, Fakiris AJ, et al. Postoperative radiotherapy after surgical resection of thymoma: differing roles in localized and regional disease. Int J Radiat Oncol Biol Phys, 2010, 76(2): 440-445.
27. Rimner A. Postoperative radiotherapy: not all thymic malignancies are created equal. Cancer, 2015, 121(7): 972-974.
28. 付浩, 中国胸腺瘤协作组全体成员, Frank Detterbeck. 胸腺肿瘤预后因素的现状. 中国肺癌杂志, 2014, 17(2): 130-132.Ref.
29. Song Z, Jin X, Zhang Y. Treatment and prognosis of type B2 thymoma. World J Surg Oncol, 2014, 12: 291.

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