He Zelai, Zhang Huijun, Cui Zhen, Jing Qijun, Zhang Zhe, Shen Yong, Liu Jingjing, Huang Jingwen
Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University & Tumor Hospital Affiliated to Bengbu Medical University, Bengbu 233004, China.
Anhui Province Key Laboratory of Translational Cancer Research Affiliated to Bengbu Medical University, Bengbu 233030, China.
Ann Transl Med. 2019 Jun;7(12):274. doi: 10.21037/atm.2019.05.34.
Type AB thymoma associated with multiple metastases is rarely encountered. This paper describes the therapeutic effect of new radiotherapy, helical tomotherapy (TOMO), in a thymoma patient with multiple metastases. A male patient aged 52 was diagnosed as type AB thymoma with multiple metastases. Two-cycle chemotherapy was administered as the primary therapy. The efficacy evaluation indicated progressive disease (PD), so radiotherapy was added to the initial treatment. The re-evaluation of efficacy indicated PD under chemotherapy and partial response (PR) in the radiotherapy area, so the latter treatment was changed to TOMO. The TOMO treatment was effective. However, due to the severe bone marrow suppression, the radiotherapy was stopped, and the patient was discharged. We concluded that the development of type AB thymoma associated with multiple metastases was fast, and the patient was sensitive to radiotherapy but not chemotherapy. Thus, TOMO can be selected as the primary palliative therapeutic regimen for chemotherapy-resistant thymoma patients, but the patient tolerance of TOMO requires careful evaluation and further clinical study.
伴有多处转移的AB型胸腺瘤很少见。本文描述了新型放疗技术螺旋断层放疗（TOMO）对一名伴有多处转移的胸腺瘤患者的治疗效果。一名52岁男性患者被诊断为伴有多处转移的AB型胸腺瘤。最初给予两周期化疗作为主要治疗。疗效评估显示疾病进展（PD），因此在初始治疗中增加了放疗。疗效重新评估显示化疗期间疾病进展，而放疗区域出现部分缓解（PR），因此将后续治疗改为TOMO。TOMO治疗有效。然而，由于严重的骨髓抑制，放疗停止，患者出院。我们得出结论，伴有多处转移的AB型胸腺瘤进展迅速，患者对放疗敏感但对化疗不敏感。因此，TOMO可作为化疗耐药胸腺瘤患者的主要姑息治疗方案，但TOMO的患者耐受性需要仔细评估并进一步开展临床研究。
