Yoshida H, Yasuda S, Aruga T, Isobe K, Aruga M, Itami J, Hatano K, Aburano T
Department of Radiology, Asahikawa Medical College.
Nihon Igaku Hoshasen Gakkai Zasshi. 1995 Nov;55(14):968-71.
We retrospectively reviewed the case histories of 45 patients with invasive thymoma who underwent postoperative or definitive radiotherapy. Patients in stage II or stage III were classified according to the treatment volume as follows: a) those who received irradiation confined to the primary tumor site with a generous margin (involved field group, n = 17) and b)those who received prophylactic whole mediastinal irradiation with or without entire hemithoracic irradiation (prophylactic group, n = 21). Seven recurrences were observed among the involved field group, while all patients in the prophylactic group were relapse-free and alive after a median follow-up interval of 50 months. Major side effects were observed in two patients who received entire hemithoracic irradiation. One developed severe pneumonitis resulting in lung fibrosis that required hospitalization, while the other developed nephrotic syndrome of unknown cause. We conclude that whole mediastinal irradiation with or without entire hemithoracic irradiation can be used as a treatment of choice for postoperative invasive thymoma.
我们回顾性分析了45例接受术后放疗或根治性放疗的侵袭性胸腺瘤患者的病历。II期或III期患者根据治疗范围分类如下：a）接受局限于原发肿瘤部位并带有足够边缘的照射的患者（受累野组，n = 17），b）接受预防性全纵隔照射（伴或不伴全半胸照射）的患者（预防组，n = 21）。受累野组观察到7例复发，而预防组所有患者在中位随访期50个月后均无复发且存活。接受全半胸照射的2例患者出现了主要副作用。1例发生严重肺炎，导致肺纤维化，需要住院治疗，另1例出现病因不明的肾病综合征。我们得出结论，全纵隔照射伴或不伴全半胸照射可作为术后侵袭性胸腺瘤的首选治疗方法。
