Maruyama Riichiroh, Suemitsu Ryuichi, Okamoto Tatsuro, Kojo Miyako, Aoki Yoshiro, Wataya Hiroshi, Eguchi Takashi, Nishiyama Kenichi, Seto Takashi, Ichinose Yukito
Department of Thoracic Oncology, Kyushu Cancer Center, Fukuoka, Japan.
Oncology. 2006;70(5):325-9. doi: 10.1159/000097944. Epub 2006 Dec 12.
The aim of this study is to retrospectively evaluate the role of several therapies, mainly chemotherapy, for thymic carcinoma (TC).
From July 1973 to July 2005, 25 patients (15 males and 10 females) with histologically proven TC were treated at our department. The median age of the patients was 59 years, with a range of from 30 to 78 years. According to Masaoka's staging system, there was 1 stage I patient, 3 stage II, 7 stage III, 6 stage IVa, and 8 stage IVb patients. The histological subtype was in all cases squamous cell carcinoma, nonkeratinizing type.
There were 6 complete surgical resections, 1 incomplete resection followed by chemoradiotherapy, 6 with radiotherapy alone, 3 with radiotherapy plus chemotherapy, and 9 with chemotherapy alone as the initial treatment. Eighteen patients were administered second-line therapy. The regimen obtaining the best response rate was doublet chemotherapy consisting of carboplatin (CBDCA) and paclitaxel. The median survival time and survival rate at 5 years for the patients excluding surgical cases with stage I/II disease were 32 months and 31%, respectively.
The doublet of CBDCA and paclitaxel thus appears to be a promising regimen for TC and further investigation in a multi-institutional phase II trial is, therefore, strongly called for.
本研究旨在回顾性评估多种治疗方法，主要是化疗，对胸腺癌（TC）的作用。
1973年7月至2005年7月，我科收治了25例经组织学证实为胸腺癌的患者（男性15例，女性10例）。患者的中位年龄为59岁，年龄范围为30至78岁。根据Masaoka分期系统，有1例I期患者，3例II期，7例III期，6例IVa期和8例IVb期患者。所有病例的组织学亚型均为鳞状细胞癌，非角化型。
有6例完全手术切除，1例不完全切除后行放化疗，6例单纯放疗，3例放疗加化疗，9例单纯化疗作为初始治疗。18例患者接受了二线治疗。获得最佳缓解率的方案是由卡铂（CBDCA）和紫杉醇组成的双联化疗。排除I/II期疾病手术病例的患者的中位生存时间和5年生存率分别为32个月和31%。
因此，CBDCA和紫杉醇的双联方案似乎是胸腺癌的一种有前景的方案，因此强烈呼吁在多机构II期试验中进行进一步研究。
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