Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy.
Curr Opin Oncol. 2012 Mar;24(2):117-22. doi: 10.1097/CCO.0b013e32834ea6bb.
Thymomas are the most common tumors of the anterior mediastinum. Although surgery remains the only curative treatment, the use of multimodality therapy for primary unresectable thymomas has led to change the clinical management of these tumors.
Nowadays Masaoka stage, WHO, and radical surgical resection are considered by many authors as independent prognostic factors for long-term survival. Radiotherapy may be useful as adjuvant therapy in cases of incomplete surgical resection with microscopic or macroscopic residual disease, or for those patients with locally advanced or metastatic unresectable disease. Chemotherapy is considered a valid option in selected patients with residual disease after local treatments or as a neoadjuvant approach to improve resectability in Masaoka stages III or IV-a thymomas. Currently, no standardized regimen for chemotherapy or agreed timing exists.
So far, multimodality treatment has been related to low morbidity and long survival rate, but there are still many concerns regarding a different regimen of therapy and the correct timing.
胸腺瘤是前纵隔最常见的肿瘤。虽然手术仍然是唯一的治愈性治疗方法，但对原发性不可切除胸腺瘤采用多模式治疗已经改变了这些肿瘤的临床处理方式。
如今，Masaoka 分期、世界卫生组织（WHO）和根治性手术切除被许多作者认为是长期生存的独立预后因素。放射治疗对于手术切除不完全的病例，无论是显微镜下还是肉眼下有残留疾病，或者对于局部晚期或转移性不可切除的疾病患者，可能是有用的辅助治疗方法。在局部治疗后有残留疾病的患者中，化疗被认为是一种有效的选择，或者作为新辅助治疗方法来提高 Masaoka 分期 III 或 IV-a 胸腺瘤的可切除性。目前，尚无化疗的标准化方案或商定的时间。
到目前为止，多模式治疗与低发病率和高生存率相关，但对于不同的治疗方案和正确的时机仍存在许多关注。
