Chemoradiotherapy for unresectable cases of thymic epithelial tumors: a retrospective study

J Thorac Dis. 2017 Oct;9(10):3911-3918. doi: 10.21037/jtd.2017.08.133.

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.

Keywords: Thymic epithelial tumor (TET); chemoradiotherapy; concurrent; sequential; thymic carcinoma; thymoma.