Guy's Cancer Centre, Great Maze Pond, London SE1 9RT, UK.
Cannizzaro Hospital, via Messina 829, 95126, Catania, Italy.
Future Oncol. 2017 Nov;13(27):2429-2439. doi: 10.2217/fon-2017-0236. Epub 2017 Nov 10.
The treatment of patients with recurrent or progressive thymic epithelial tumors remains uncertain due to limited data in this rare disease.
MATERIALS & METHODS: A retrospective 10-year monoinstitutional analysis was conducted on 25 patients with first recurrence or disease progression following primary treatment.
Twenty patients had thymoma, five thymic carcinomas. Ten patients (40%) received surgery, four (40%) following chemotherapy; 17 (68%) had chemotherapy, with a combination regimen in 16 of them (94%). Surgery had a significant effect both on overall survival and progression-free survival-2 by univariate analysis (p = 0.04), combination chemotherapy only on progression-free survival-2 (p = 0.03).
Combination chemotherapy and surgery at first recurrence/progression of thymic epithelial tumors were associated with improved survival.
Although several limitations may have affected this retrospective study on a relatively small number of patients with this rare entity of recurrent thymic malignancies, we suggest the use of combination chemotherapy and surgery at their first recurrence may have contributed to the high overall and progression-free survival observed with adequate follow-up and deserve further investigations in broader retrospective and comparative studies.
由于这种罕见疾病的数据有限,复发性或进展性胸腺瘤患者的治疗仍然不确定。
对 25 例经初次治疗后首次复发或疾病进展的患者进行了 10 年的单机构回顾性分析。
20 例患者为胸腺瘤,5 例为胸腺癌。10 例患者(40%)接受了手术,4 例(40%)接受了化疗;17 例患者(68%)接受了化疗,其中 16 例患者(94%)采用联合方案。单因素分析显示,手术对总生存和无进展生存-2 均有显著影响(p=0.04),联合化疗仅对无进展生存-2 有影响(p=0.03)。
胸腺癌初次复发/进展时采用联合化疗和手术治疗可提高生存率。
尽管该研究对这一罕见复发性胸内恶性肿瘤实体的患者数量相对较少,且存在一些局限性,但我们建议,初次复发时采用联合化疗和手术治疗可能有助于观察到较高的总生存率和无进展生存率,在充分随访的情况下,这一方法值得进一步在更广泛的回顾性和对比研究中进行探讨。