Cancer Res Treat.  2012 Sep;44(3):166-172.

Is There a Role of Postoperative Radiation Therapy in Completely Resected Stage I/II Thymic Epithelial Tumor?

• Oh D
• Ahn YC
• Kim K
• Kim J
• Shim YM
• Han J

Abstract

PURPOSE
Retrospective analyses of patients with stage I-II thymic epithelial tumors (TET) who were treated with either surgery alone (S) or surgery plus postoperative radiation therapy (SRT) were conducted to evaluate the role of adjuvant radiation therapy (RT).
MATERIALS AND METHODS
A total of 110 stage I-II TET patients following complete resection were included in this study. Postoperative radiation therapy was recommended for those with aggressive histologic type and/or invasive features according to the surgeons' judgment during the operation. A median dose of 54.0 Gy (range, 44 to 60 Gy) focused on the primary tumor bed was administered to 57 patients (51.8%).
RESULTS
In all patients, the rates of overall survival, disease-specific survival, and disease-free survival at 10 years were 91.7%, 97.1%, and 95.8%, respectively. No significant differences in disease-specific survival (100% in the S group and 93.5% in the SRT group at 10 years, p=0.12) and disease-free survival (98.1% in the S group and 94.5% in the SRT group at 10 years, p=0.41) were observed between the treatment groups, although a significantly larger number of World Health Organization (WHO)-type B2-C (p<0.001) and Masaoka stage II (p=0.03) tumors were observed in the SRT group than in the S group. No local recurrence was observed in the SRT group. No grade 2 or greater RT-related toxicities were observed in the SRT group.
CONCLUSION
Excellent outcomes were achieved in patients with stage I-II TET who underwent complete resection. Considering excellent local control and low morbidity, adjuvant RT may be considered in high risk patients with WHO-type B2-C histology and Masaoka stage II.

Keyword

Thymic neoplasms; Surgery; Adjuvant radiotherapy

MeSH Terms

Disease-Free Survival
Humans
Judgment
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
Thymus Neoplasms
World Health Organization

Figure

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  Fig. 1 The typical beam arrangement of three-dimensional conformal radiation therapy (anterior/right anterior oblique/left anterior oblique).

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  Fig. 2 Comparison of survival rates according to adjuvant radiation therapy (RT) in stage I and stage II thymic epithelial tumor. S, surgery alone; SRT, surgery plus RT.

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