HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Cameron D. Wright Noah C. Choi John C. Wain Douglas J. Mathisen Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wright, C. D. Articles by Fidias, P. Search for Related Content PubMed PubMed Citation Articles by Wright, C. D. Articles by Fidias, P. Related Collections Mediastinum Related Article

---

Original Articles: General Thoracic

Induction Chemoradiotherapy Followed by Resection for Locally Advanced Masaoka Stage III and IVA Thymic Tumors

^a Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts
^b Division of Medical Oncology, Massachusetts General Hospital, Boston, Massachusetts
^c Division of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts

Accepted for publication August 22, 2007.

^_* Address correspondence to Dr Wright, Massachusetts General Hospital, Thoracic Surgery, Blake 1570, 55 Fruit St, Boston, MA 02114 (Email: wright.cameron{at}mgh.harvard.edu).

Background: The treatment of locally advanced thymic tumors is not uniform. Recently, several centers have reported the results of induction chemotherapy followed by resection and then radiation. Our center adopted an alternative strategy and treated locally advanced thymic tumors with induction chemoradiotherapy in an effort to maximize the intensity of the induction therapy.

Methods: A retrospective review was performed of 10 patients with locally advanced thymic tumors treated from 1997 to 2006. Seven patients were clinically staged as Masaoka stage III and 3 as stage IVA. The treatment plan included two cycles of cisplatin and etoposide with concurrent radiation. Patients then had resection followed by postoperative chemotherapy if they were judged to be at high risk for relapse.

Results: Four patients had a partial radiographic response to induction therapy and 6 had no response. Eight patients had a R0 resection and 2 had a R1 resection. Four patients had substantial (>90%) necrosis in the resected specimen. There was no postoperative mortality. Seven patients had two more cycles of chemotherapy. The median follow-up was 41 months. Three patients had recurrences. The 5-year estimated survival was 69% (95% confidence interval: 32% to 100%).

Conclusions: Induction therapy for locally advanced thymic tumors with cisplatin, etoposide, and radiation is well tolerated, with many patients having a partial radiographic response. The majority of patients can undergo a complete resection with this treatment. The survival of these patients compares favorably with those undergoing other induction regimens. Further efforts to maximize the intensity of induction therapy for locally advanced thymic tumors is warranted. We have initiated a multicenter phase 2 clinical trial (NCT00387868) to prospectively test this concept.

Related Article

Multimodality Therapy for Locally Advanced Thymomas: State of the Art or Investigational Therapy?

James Huang, Gregory J. Riely, Kenneth E. Rosenzweig, and Valerie W. Rusch
Ann. Thorac. Surg. 2008 85: 365-367. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				S. Tomaszek, D. A. Wigle, S. Keshavjee, and S. Fischer Thymomas: Review of Current Clinical Practice. Ann. Thorac. Surg., June 1, 2009; 87(6): 1973 - 1980. [Abstract] [Full Text] [PDF]

				H. E. Cohn Successful Long-Term Outcome in Locally Advanced Masaoka IVA Thymoma With Induction Chemotherapy Followed by Complete Resection and Adjuvant Radiotherapy Ann. Thorac. Surg., November 1, 2008; 86(5): 1725 - 1725. [Full Text] [PDF]

				C. D. Wright Reply Ann. Thorac. Surg., November 1, 2008; 86(5): 1725 - 1725. [Full Text] [PDF]

				J. Huang, G. J. Riely, K. E. Rosenzweig, and V. W. Rusch Multimodality Therapy for Locally Advanced Thymomas: State of the Art or Investigational Therapy? Ann. Thorac. Surg., February 1, 2008; 85(2): 365 - 367. [Full Text] [PDF]