Thymoma medical therapy: Difference between revisions
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====Chemotherapy==== | ====Chemotherapy==== | ||
*Chemotherapy is used in '''locally advanced''' thymomas, after which patients are re-evaluated for resectability. | |||
*In cases of '''isolated solitary metastasis''', surgery may be attempted before any chemotherapy is administered. | |||
Most of the chemotherapy | *Chemotherapy is also used if there is evidence of '''distant metastasis'''. | ||
*Most of the chemotherapy regimens used are based on [[cisplatin]] and [[anthracyclines]]. | |||
====Corticosteroids==== | ====Corticosteroids==== | ||
Revision as of 17:08, 28 September 2015
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Thymoma Microchapters |
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Diagnosis |
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Case Studies |
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Thymoma medical therapy On the Web |
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American Roentgen Ray Society Images of Thymoma medical therapy |
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Risk calculators and risk factors for Thymoma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]
Overview
Chemotherapy and radiotherapy are used as adjuvant or neoadjuvant therapies. Neoadjuvant therpy may be administered prior to surgery to make the tumor resectable.
Medical Therapy
| Resectable | Resection of primary tumor & isolated metastasis | Consider postoperative radiotherapy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Locally advanced | Chemotherapy | Re-evaluate for surgery | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Unresectable | Radiotherapy +/- chemotherapy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Chemotherapy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Thymoma | Isolated solitary metastasis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Surgery | Consider chemotherapy or radiotherapy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Evidence of distant metastasis | Chemotherapy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adopted from the NCCN treatment algorithm[1]
Chemotherapy
- Chemotherapy is used in locally advanced thymomas, after which patients are re-evaluated for resectability.
- In cases of isolated solitary metastasis, surgery may be attempted before any chemotherapy is administered.
- Chemotherapy is also used if there is evidence of distant metastasis.
- Most of the chemotherapy regimens used are based on cisplatin and anthracyclines.
Corticosteroids
Corticosteroids may be used in unresectable tumors that have been refractory to radiation therapy leading to transient partial responses.[2] Similar to the effects of ageing and stress, steroids increase thymic fat and connective tissue and decrease corticomedullar differentiation. Therefore in WHO subtypes A and B thymoma, corticosteroids produce tumour size reduction due to lymphocyte depletion.[3]
References
- ↑ "https://www.nccn.org/store/login/login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/thymic.pdf" (PDF). External link in
|title=(help) - ↑ "http://www.cancernet.nci.nih.gov/cancertopics/types/thymoma". External link in
|title=(help) - ↑ "Octreotide alone or with prednisone in patients... [J Clin Oncol. 2004] - PubMed - NCBI".