Okuma Yusuke, Hosomi Yukio, Takahashi Satoshi, Maeda Yoshiharu, Okamura Tatsuru, Hishima Tsunekazu
Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan; Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan.
Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.
Clin Lung Cancer. 2015 May;16(3):221-7. doi: 10.1016/j.cllc.2014.10.006. Epub 2014 Oct 31.
Clinical efficacy of second- and later-line chemotherapy for patients with thymic carcinoma previously treated with chemotherapy remains uncertain; limited data are available about this carcinoma because of its rarity. The aim of this study was to investigate effective chemotherapy for patients with thymic carcinoma previously treated with chemotherapy using a retrospective analysis of responses and times to event.
We conducted a retrospective review of the medical records of 23 advanced thymic carcinoma patients previously treated with palliative-intent chemotherapy between 1980 and 2014 in our institution. Clinical demographic characteristics, agents, response, and time to treatment failure for each treatment line and overall survival were reviewed. Factors expected to be associated with survival rates were analyzed. Differences in survival were assessed using Kaplan-Meier analysis and univariate and multivariate Cox proportional hazards regression analyses.
The study included 13 men (56.5%) and 10 women (43.5%). The median age at diagnosis was 58.5 years. The most common histological subtypes were squamous cell carcinoma (16 patients [69.6%]), followed by neuroendocrine carcinoma (4 patients [17.4%]). The objective response rates of first-, second-, third-, and fourth-line chemotherapy were 60.9%, 39.1%, 23.1%, and 25.0%, respectively. The median survival time was 18.8 months (95% confidence interval, 7.5-40.9 months). Uni- and multivariate analyses of all assessed variables failed to identify any statistically significant indicators of overall survival.
Patients with thymic carcinoma previously treated with palliative-intent chemotherapy might respond to second- or later-lines of cytotoxic chemotherapy.
对于先前接受过化疗的胸腺癌患者，二线及后续化疗的临床疗效仍不确定；由于胸腺癌罕见，关于这种癌症的数据有限。本研究的目的是通过对反应和事件发生时间进行回顾性分析，调查先前接受过化疗的胸腺癌患者的有效化疗方案。
我们对1980年至2014年间在本机构接受姑息性化疗的23例晚期胸腺癌患者的病历进行了回顾性研究。回顾了每个治疗线的临床人口统计学特征、药物、反应、治疗失败时间和总生存期。分析了预期与生存率相关的因素。使用Kaplan-Meier分析以及单变量和多变量Cox比例风险回归分析评估生存差异。
该研究包括13名男性（56.5%）和10名女性（43.5%）。诊断时的中位年龄为58.5岁。最常见的组织学亚型是鳞状细胞癌（16例患者[69.6%]），其次是神经内分泌癌（4例患者[17.4%]）。一线、二线、三线和四线化疗的客观缓解率分别为60.9%、39.1%、23.1%和25.0%。中位生存时间为18.8个月（95%置信区间，7.5 - 40.9个月）。对所有评估变量进行的单变量和多变量分析均未发现任何具有统计学意义的总生存指标。
先前接受过姑息性化疗的胸腺癌患者可能对二线或后续细胞毒性化疗有反应。
