Title: Retrospective Study on Port in Adult Thymoma
Authors: Dr Shweta Mohata, Dr H.S. Kumar, Dr Neeti Sharma, Dr S.L. Jakhar, Dr S. Beniwal, Dr Kamlesh Kumar Harsh
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.43
Abstract
Introduction: Thymoma is a rare neoplasm, and the role of post-operative radiotherapy (PORT) in thymoma is still controversial. We performed an institute based retrospective study to analyze the impact of PORT on overall survival (OS).
Methods: We analyzed total 13 patients of thymoma, who were operated outside and come to our institute for PORT during 2010-2018. There were stage I & IIA (3), IIB (7), III (2), IVA (1) patients according to Masoaka –Koga staging system. Surgery done was complete resection (10), partial resection (2), only biopsy (1). Three patients of early I and IIA stage, had not received any RT. Two patients of stage II B with complete resected tumor had refused radiotherapy. Total 8 patients were irradiated with a mean dose of 50.4 Gy (50.4 – 60 Gy). There was 1 patient in PORT and 1 patient in only surgery arm with IIB stage had positive surgical margins. Patients with WHO grade B2 were four, while rest of the nine patients were having grade B3. Three patients were having associated myasthenia gravis two in PORT and 1 in surgery only arm, and were taking treatment for that. Median follow up period was 66 months (1-78 months).
Result: Out of 8 patients under PORT, 5 (62.5%) were alive till December 2018, one patient had not completed RT because of acute RT reactions, two patients were dead after RT completion, and cause of death was associate myasthenia gravis in one, while one was died because of thymoma. In surgery alone group, two patients (40%) were alive, one was expired due to cardiac arrest and two patients were dead because of the disease.
Conclusion: PORT improved overall survival in patients of thymoma especially in stage II B, III and positive surgical margins.
Keywords: Thymoma, PORT, OS.
References
- Engels EA. Epidemiology of thymoma and associated malignancies. J Thorac Oncol 2010;5:S260-5.
- Qu YJ, Liu GB, Shi HS, et al. Preoperative CT findings of thymoma are correlated with postoperative Masaoka clinical stage. Acad Radiol 2013;20:66-72.
- NCCN guidelines version 2.2018. Thymomas and thymic carcinomas. http://www.nccn.org/professionals/physician_gls/pdf/thymic.pdf
- Utsumi, T., Shiono, H., Kadota, Y. et al. Postoperative radiation therapy after complete resection of thymoma has little impact on survival. Cancer. 2009; 115: 5413–5420.
- Korst, R.J., Kansler, A.L., Christos, P.J., and Mandal, S. Adjuvant radiotherapy for thymic epithelial tumors: a systematic review and meta-analysis. Ann Thorac Surg. 2009; 87: 1641–1647
- Rena, O., Papalia, E., Oliaro, A. et al. Does adjuvant radiation therapy improve disease-free survival in completely resected Masaoka stage II thymoma?. Eur J Cardiothorac Surg. 2007; 31: 109–113
- Boothe, D., Orton, A., Thorpe, C., Kokeny, K., and Hitchcock, Y.J. Postoperative radiotherapy in locally invasive malignancies of the thymus: patterns of care and survival. J Thorac Oncol. 2016; 11: 2218–2226
- Lim, Y.J., Kim, H.J., and Wu, H.-G. Role of postoperative radiotherapy in nonlocalized thymoma: propensity-matched analysis of Surveillance, Epidemiology, and End Results Database J Thorac Oncol.2015; 10: 1357–1363
- Fernandes, A.T., Shinohara, E.T., Guo, M. et al. The role of radiation therapy in malignant thymoma: a Surveillance, Epidemiology, and End Results database analysis. J Thorac Oncol. 2010;5: 1454–1460