Japanese Journal of Clinical Oncology, Vol 29, Issue 10 474-478, Copyright © 1999 by Foundation for Promotion of Cancer Research
K Ogawa, T Toita, Y Kakinohana, M Kamata, K Koja and K Genga
BACKGROUND: Optimal management of postoperative radiation therapy for
completely resected invasive thymoma remains controversial. This study was
conducted to assess the efficacy of postoperative mediastinal irradiation
in patients with completely resected invasive thymoma. METHODS: Between
1981 and 1996, 21 patients with completely resected invasive thymoma were
referred for postoperative mediastinal irradiation. The distribution of
Masaoka stages was stage II in 14 patients and stage III in seven patients.
Nine patients had pleural invasion by the tumor. Thirteen patients were
treated with a localized field and eight were treated with the whole
mediastinal field with boost. The total dose to the primary tumor was 40-61
Gy (median: 52 Gy). The median follow-up time of the 16 living patients was
67 months (range: 29-202 months). RESULTS: The 5- and 10-year actuarial
overall survival rates in all patients were both 77%. Relapses were
observed in five patients, in all of whom the sites of the first relapse
involved pleural dissemination. There were no relapses within the
irradiated field in any of the 21 cases. Five of nine (56%) patients with
pleural invasion had relapse of pleural dissemination, while 0 of 12 (0%)
patients without pleural invasion had relapse. In univariate analysis,
pleural invasion had a statistically significant impact on intrathoracic
control (P = 0.01). CONCLUSIONS: The results indicated that pleural
invasion might be predictive of pleural-based relapse for completely
resected invasive thymoma. In patients with pleural invasion, mediastinal
irradiation alone might be insufficient to avoid pleural-based relapse even
after complete resection.
CASE REPORTS
Postoperative radiation therapy for completely resected invasive thymoma: prognostic value of pleural invasion for intrathoracic control
Department of Radiology, University of the Ryukyus School of Medicine, Okinawa, Japan. kogawa@med.u-ryukyu.ac.jp
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