Zhai Yirui, Hui Zhouguang, Gao Yushun, Liang Jun, Zhou Zongmei, Wang Luhua, Feng Qinfu
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of VIP Medical Service, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Thorac Cardiovasc Surg. 2020 Aug;68(5):440-445. doi: 10.1055/s-0039-1688723. Epub 2019 May 28.
Total resection may not be achieved in patients with thymic carcinoma, particularly those with Masaoka stage III disease. Debulking surgery plus postoperative radiotherapy and radiation alone are treatment options for such patients. We aimed to compare the overall survival (OS) between patients with thymic carcinoma who underwent debulking surgery plus postoperative radiotherapy and those who underwent radiation alone.
This was a single-center retrospective study of patients histologically diagnosed as having Masaoka stage III thymic carcinoma between January 1980 and January 2010. Patients were classified into the following groups according to treatments received: debulking surgery plus radiotherapy (group A) and radiotherapy alone (group B). Data on demographics, histology, invasion, radiotherapy, chemotherapy, and survival were collected. Survival time was calculated and compared between the groups using the Kaplan-Meier method. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0.
Of the 47 enrolled patients, 26 and 21 patients were categorized into groups A and B, respectively. There are no significant differences in the Eastern Cooperative Oncology Group performance status score, histological type, great vessel invasion, and chemotherapy proportion between the groups. The median radiation dose was 60 Gy in both groups. The 5-year OS rates were 54.4 and 0% in groups A and B, respectively ( = 0.019). No operation-induced mortality was recorded.
For patients with unresectable Masaoka stage III disease, debulking surgery with radiotherapy is preferred, as this was proven to be more efficient than the radiation-alone procedure.
胸腺癌患者可能无法实现完全切除，特别是那些Masaoka III期疾病患者。减瘤手术加术后放疗以及单纯放疗是这类患者的治疗选择。我们旨在比较接受减瘤手术加术后放疗的胸腺癌患者与接受单纯放疗的患者的总生存期（OS）。
这是一项单中心回顾性研究，研究对象为1980年1月至2010年1月间组织学诊断为Masaoka III期胸腺癌的患者。根据接受的治疗将患者分为以下几组：减瘤手术加放疗（A组）和单纯放疗（B组）。收集了人口统计学、组织学、侵犯情况、放疗、化疗和生存的数据。使用Kaplan-Meier方法计算并比较两组的生存时间。根据美国国立癌症研究所不良事件通用术语标准第3.0版对毒性进行分级。
在47名入组患者中，分别有26名和21名患者被归入A组和B组。两组之间在东部肿瘤协作组体能状态评分、组织学类型、大血管侵犯和化疗比例方面无显著差异。两组的中位放疗剂量均为60 Gy。A组和B组的5年总生存率分别为54.4%和0%（P = 0.019）。未记录到手术引起的死亡。
对于无法切除的Masaoka III期疾病患者，首选减瘤手术加放疗，因为事实证明这比单纯放疗更有效。
