Radiotherapy for thymic carcinoma: Adjuvant, inductive, and definitive

Abstract

Although historically thymoma and thymic carcinoma have been treated surgically, radiation therapy also has an important role, either as postoperative therapy to reduce the risk of mediastinal recurrence or as part of definitive treatment for patients who cannot undergo surgery. Induction chemotherapy and molecular targeted agents may also be appropriate for thymic carcinoma, the behavior of which resembles non-small-cell lung carcinoma more than that of thymoma or invasive thymoma and is increasingly being treated like lung cancer. We present here a review of current therapies for thymic malignancies and briefly discuss the potential benefits from novel technologies for such treatment. Thymic malignancies, although the most common primary neoplasms of the anterior mediastinum, are relatively rare. The course of disease can range from indolent to quite aggressive, making the choice of treatment and analysis of outcomes challenging. The few prospective trials that have included patients with advanced-stage disease involved heterogeneous treatments (1). Retrospective and prospective analyses have demonstrated promising survival rates for patients undergoing trimodality therapy (chemotherapy, surgery, and radiation therapy) for advanced invasive thymoma (2-5) or thymic carcinoma (6-8). However, investigations that include large numbers of patients from several institutions are sparse, particularly those that compare patients who received different types of treatments. © 2014 Komaki and Gomez.