First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Oncologist. 2020 Apr;25(4):e668-e674. doi: 10.1634/theoncologist.2019-0593. Epub 2019 Nov 26.
Owing to the rarity of this tumor, there is limited information about second-line chemotherapy for patients with previously treated advanced thymic carcinoma.
We performed a multi-institutional, retrospective study named NEJ023 for patients with advanced thymic carcinoma. Patients without indications for curative treatment were treated with chemotherapy from 1995 to 2014 at 40 institutions in the North East Japan Study Group. Demographic and clinicopathologic characteristics, data on treatment methods, and outcomes of second-line chemotherapy were obtained from medical records.
In total, 191 patients were enrolled in this study. Second-line chemotherapy included platinum-based doublets in 57.6% of patients, other multidrug chemotherapy (e.g., cisplatin, doxorubicin, vincristine, and cyclophosphamide) in 13.6%, and monotherapy in 28.8%. The median follow-up time was 50.5 months, and the median overall survival (OS) from the start of second-line chemotherapy was 22.4 (95% confidence interval, 17.5-26.7) months. The average response rate (RR) was 20.0% overall; it was 21.6% for patients treated with platinum-based doublet chemotherapy, 13.6% for those treated with other multidrug chemotherapy, and 19.6% for those treated with single agent chemotherapy. There was no significant difference in OS between platinum-based doublet chemotherapy, other multidrug chemotherapy, and monotherapy (the median OS was 22.4, 25.7, and 21.4 months, respectively).
The median OS was 22.4 months in patients with advanced thymic carcinoma treated with second-line chemotherapy. There were no significant differences in RR and OS between monotherapy and multidrug chemotherapy in this study.
Owing to the rarity of this tumor, there is limited information about second-line chemotherapy for patients with previously treated advanced thymic carcinoma. This is the largest data for those patients treated with second-line chemotherapy. This study suggests there is no significant difference in efficacy between monotherapy and multidrug chemotherapy for previously treated advanced thymic carcinoma. This result can support the adequacy to select monotherapy as treatment of those patients.
由于这种肿瘤较为罕见，对于先前接受过治疗的晚期胸腺癌患者的二线化疗，相关信息有限。
我们进行了一项名为 NEJ023 的多机构回顾性研究，纳入了晚期胸腺癌患者。1995 年至 2014 年期间，来自东北日本研究组的 40 家机构对不适合根治性治疗的患者进行化疗。我们从病历中获取了患者的人口统计学和临床病理学特征、治疗方法的数据以及二线化疗的结果。
本研究共纳入 191 例患者。二线化疗中，铂类双药化疗占 57.6%，其他多药化疗（如顺铂、多柔比星、长春新碱和环磷酰胺）占 13.6%，单药化疗占 28.8%。中位随访时间为 50.5 个月，二线化疗开始后中位总生存期（OS）为 22.4（95%置信区间，17.5-26.7）个月。总体平均缓解率（RR）为 20.0%；铂类双药化疗组为 21.6%，其他多药化疗组为 13.6%，单药化疗组为 19.6%。铂类双药化疗、其他多药化疗与单药化疗的 OS 无显著差异（中位 OS 分别为 22.4、25.7 和 21.4 个月）。
先前接受过治疗的晚期胸腺癌患者二线化疗的中位 OS 为 22.4 个月。在本研究中，单药与多药化疗的 RR 和 OS 无显著差异。
由于这种肿瘤较为罕见，对于先前接受过治疗的晚期胸腺癌患者的二线化疗，相关信息有限。本研究是针对此类患者接受二线化疗的最大规模数据。该研究表明，先前接受过治疗的晚期胸腺癌患者，单药与多药化疗的疗效无显著差异。该结果可为选择单药治疗提供支持。
