Sandbox/thy10

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ABC

Thymoma or Thymic Carcinoma

Locally Advanced

Solitary Metastasis

Distant metastasis

Chemotherapy

Chemotherapy

Surgery

Chemotherapy

Re-evaluate for surgery

Chemotherapy or RT

Resectable

Unresectable

Surgery ± Postoperative RT

RT ± Chemotherapy

Chemotherapy Regimens

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Radiation Dose

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• A dose of 60-70 Gy should be given to patients with unresectable disease.

• For adjuvant treatment, the radiation dose consists of 45-50 Gy for clear/close margins and 54 Gy for microscopically positive resection margins. A total dose of 60 Gy and above should be given to patients with gross residual disease (similar to patients with unresectable disease), when conventional fractionation (1.8 to 2.0 Gy per daily fraction) is applied.