Fan C Y, Huang W Y, Jen Y M, Lin M J, Lin K T
Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;
Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Curr Oncol. 2015 Oct;22(5):e391-4. doi: 10.3747/co.22.2693.
Thymic carcinoma is a rare but lethal mediastinal cancer. The optimal treatment for advanced thymic carcinoma is not yet established. This report is the first known of stereotactic ablative radiotherapy (sabr) with CyberKnife (Accuray, Sunnyvale, CA, U.S.A.) as definitive therapy for thymic carcinoma. The patient, a 70-year-old woman with thymic carcinoma, invasion into neighboring organs, and pleural metastases-underwent CyberKnife sabr at 40 Gy in 5 fractions for two lesions, one in the thymus and one in the right paraspinal pleura. After 61 months of observation, a partial response was observed in the irradiated fields. However, disease progression in the non-irradiated pleura was noted. The patient underwent salvage CyberKnife sabr for the four initially nonirradiated pleural lesions. Computed tomography images obtained 10 months after the salvage therapy revealed a partial response. The patient is living, with progression-free irradiated lesions and no radiation-related toxicity. CyberKnife sabr is feasible for patients who are unable to undergo either surgery or conventionally fractionated radiation therapy.
胸腺癌是一种罕见但致命的纵隔癌。晚期胸腺癌的最佳治疗方案尚未确定。本报告是已知的首例使用射波刀（美国加利福尼亚州森尼韦尔市Accuray公司）进行立体定向消融放疗（SABR）作为胸腺癌确定性治疗的病例。该患者为一名70岁女性，患有胸腺癌，侵犯邻近器官并伴有胸膜转移，针对胸腺和右椎旁胸膜的两个病灶接受了射波刀SABR治疗，分5次给予40 Gy剂量。观察61个月后，照射野出现部分缓解。然而，未照射的胸膜出现疾病进展。该患者针对最初未照射的四个胸膜病灶接受了挽救性射波刀SABR治疗。挽救性治疗10个月后获得的计算机断层扫描图像显示部分缓解。患者存活，照射病灶无进展且无放疗相关毒性。射波刀SABR对于无法接受手术或传统分割放疗的患者是可行的。
