Kaseda S, Horinouchi H, Kato R, Kobayashi K
Department of Thoracic Surgery, Saiseikai Kanagawa-ken Hospital, Yokohama, Japan.
Kyobu Geka. 1993 Jan;46(1):31-40.
The records of 10 patients treated for invasive thymoma with low-dose and extended-field irradiation including hemi-thorax or whole-thorax are reviewed. Six patients were in stage III. They were treated with up to 15 Gy hemi-thorax irradiation which was followed by shrinkage of the radiation field after removal of tumor. Five of them have lived 4 to 10 years, while one remaining patient died of uncertain cause. Four patients had stage IVa thymoma. Two patients in an earlier stage were treated with irradiation alone; whole-thorax irradiation of up to 20 Gy followed by local irradiation. Those two patients, however, developed severe pulmonary infection secondary to irradiation pneumonitis. Furthermore, local relapse was observed in one patient who died of respiratory insufficiency after 6 years. In the remaining 2 patients in stage IVa, intensive chemotherapy was administered before whole-thorax irradiation of up to 15 Gy. One of these patients is alive with no evidence of recurrence for 5 years, while the other died of a disease not related to thymoma. These facts indicate that whole-thorax irradiation combined with chemotherapy may be of value in preventing local relapse with stage IVa thymoma.
回顾了10例接受低剂量扩野照射（包括半胸或全胸照射）治疗侵袭性胸腺瘤患者的记录。6例患者处于Ⅲ期。他们接受了高达15 Gy的半胸照射，肿瘤切除后放疗野缩小。其中5例存活了4至10年，而剩下的1例患者死因不明。4例患者患有Ⅳa期胸腺瘤。2例早期患者仅接受了放疗；全胸照射高达20 Gy，随后进行局部照射。然而，这2例患者继发放射性肺炎后出现严重肺部感染。此外，1例患者出现局部复发，6年后死于呼吸功能不全。在其余2例Ⅳa期患者中，在全胸照射高达15 Gy之前进行了强化化疗。其中1例患者存活5年，无复发迹象，而另1例死于与胸腺瘤无关的疾病。这些事实表明，全胸照射联合化疗可能对预防Ⅳa期胸腺瘤的局部复发有价值。
