Cancer Treatment Center, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan.
Department of Thoracic Oncology, National Hospital Organization Kyusyu Cancer Center, Fukuoka, Japan.
Thorac Cancer. 2022 Sep;13(17):2499-2506. doi: 10.1111/1759-7714.14586. Epub 2022 Jul 22.
Combination chemotherapy is used to treat advanced thymic carcinoma; however, the effects are insufficient.
Previously untreated patients with unresectable locally advanced thymic carcinoma received two cycles of 80 mg/m /day S-1 orally on days 1-14 plus 60 mg/m /day cisplatin intravenously on day 1, and concurrent radiotherapy (60 Gy).
Three patients were enrolled into the study. Toxicity and survival were assessable in all patients, but the treatment response was only assessable in one patient. The study was terminated because of poor case recruitment. The patients' characteristics were as follows: male/female = 2/1; PS 0/1 = 2/1; median age (range) = 59 (55-72); and stage III/IV = 2/1. The patient in which the treatment response was assessed exhibited SD (response rate: 0%). In both nonevaluable cases, the second course of chemotherapy was judged to be post-protocol treatment because it was delayed by ≥14 days, but a CR and PR were achieved after the end of the study, respectively. G4 leukopenia/neutropenia and G3 febrile neutropenia occurred in one patient each (33%). The median time to tumor progression was 17.6 months, and the 1-, 2-, 3-, and 4-year survival rates were 67, 33, 33, and 33%, respectively. The median overall survival time was not reached, and the 1-, 2-, 3-, and 4-year survival rates were 100, 67, 67, and 67%, respectively.
Although it was difficult to recruit patients, there was a long-term survivor >4 years who appeared to have achieved a CR, indicating that such chemoradiotherapy may be effective against locally advanced thymic carcinoma.
联合化疗用于治疗晚期胸腺癌,但效果不足。
未经治疗的不可切除局部晚期胸腺癌患者接受两个周期的 80mg/m /天 S-1 口服,第 1-14 天,第 1 天静脉注射 60mg/m /天顺铂,同时进行放射治疗(60Gy)。
三名患者入组。所有患者均可评估毒性和生存情况,但仅可评估一名患者的治疗反应。由于病例招募不佳,研究终止。患者特征如下:男/女=2/1;PS 0/1=2/1;中位年龄(范围)=59(55-72);III/IV 期=2/1。接受治疗反应评估的患者表现为 SD(反应率:0%)。在两个不可评估的病例中,由于延迟≥14 天,第二疗程化疗被判定为方案后治疗,但在研究结束后分别获得了 CR 和 PR。一名患者(33%)发生 4 级白细胞减少/中性粒细胞减少和 3 级发热性中性粒细胞减少。肿瘤进展的中位时间为 17.6 个月,1、2、3 和 4 年生存率分别为 67%、33%、33%和 33%。中位总生存时间未达到,1、2、3 和 4 年生存率分别为 100%、67%、67%和 67%。
尽管患者招募困难,但有一名长期生存者>4 年,似乎已达到 CR,表明这种放化疗可能对局部晚期胸腺癌有效。