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胸腺瘤与放疗结果

Thymic tumors and results of radiotherapy.

作者信息

Sarıhan Sureyya, Bayram Ahmet Sami, Gebitekin Cengiz, Yerci Omer, Sıgırlı Deniz

机构信息

Department of Radiation Oncology, Uludag University, Faculty of Medicine, Bursa, Turkey.

Department of Thoracic Surgery, Uludag University, Faculty of Medicine, Bursa, Turkey.

出版信息

Rep Pract Oncol Radiother. 2018 Mar-Apr;23(2):97-104. doi: 10.1016/j.rpor.2017.12.002. Epub 2018 Feb 12.

Abstract

AIM

The aim of this study was to evaluate thymic epithelial tumors (TETs) for treatment outcomes and prognostic factors on survival.

BACKGROUND

TETs are very rare neoplasms and multidisciplinary approach is recommended according to prognostic factors.

MATERIALS AND METHODS

Between 1995 and 2013, 31 patients were treated with median 5400 cGy (range: 1620-6596 cGy) radiotherapy (RT). Eleven patients received adjuvant or concurrent chemotherapy. There were 25 thymomas, 4 thymic carcinomas and 2 thymic neuroendocrin carcinomas. According to Masaoka, staging and WHO classification, cases were divided to good (: 10), moderate (: 9) and poor (: 12) prognostic risk groups. Survival was calculated from diagnosis.

RESULTS

In January 2016, 22 cases were alive with median 51.5 months (range: 2-170.5) follow-up. Recurrences were observed in 29% of patients in median 29.5 months (range: 6.5-105). Local control, mean overall (OS) and disease-free survival (DFS) rates were 86%, 119 and 116 months, respectively. There was a significant difference for R0 vs. R+ resection (81% vs. 43%,  = 0.06, and 69% vs. 46%,  = 0.05), Masaoka stage I-II vs. III-IV (75% vs. 52%,  = 0.001, and 75% vs. 37%,  < 0.001), and also prognostic risk groups (100% vs. 89% vs. 48%,  = 0.003, and 100% vs. 87% vs. 27%,  = 0.004) in terms of 5-year OS and DFS, respectively.

CONCLUSION

In our study, prognostic risk stratification was shown to be a significant predictor of survival. There is a need to investigate subgroups that may or may not benefit from adjuvant RT.

摘要

目的

本研究旨在评估胸腺瘤(TETs)的治疗效果及生存预后因素。

背景

胸腺瘤是非常罕见的肿瘤,建议根据预后因素采用多学科方法进行治疗。

材料与方法

1995年至2013年间,31例患者接受了中位剂量为5400 cGy(范围:1620 - 6596 cGy)的放射治疗(RT)。11例患者接受了辅助或同步化疗。其中有25例胸腺瘤、4例胸腺癌和2例胸腺神经内分泌癌。根据Masaoka分期和世界卫生组织分类,病例被分为预后良好(n = 10)、中等(n = 9)和较差(n = 12)风险组。从诊断开始计算生存率。

结果

截至2016年1月,22例患者存活,中位随访时间为51.5个月(范围:2 - 170.5个月)。29%的患者出现复发,中位复发时间为29.5个月(范围:6.5 - 105个月)。局部控制率、平均总生存期(OS)和无病生存期(DFS)分别为86%、119个月和116个月。R0切除与R +切除相比(81%对43%,P = 0.06;69%对46%,P = 0.05)、Masaoka I - II期与III - IV期相比(75%对52%,P = 0.001;75%对37%,P < 0.001)以及预后风险组之间(5年OS分别为100%对89%对48%,P = 0.003;5年DFS分别为100%对87%对27%,P = 0.004),5年总生存期和无病生存期均存在显著差异。

结论

在我们的研究中,预后风险分层被证明是生存的重要预测因素。有必要研究可能从辅助放疗中获益或未获益的亚组。

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