Thymoma medical therapy
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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 1ry 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
It is used in locally advanced thymomas then re-evaluated for resectability. In cases of isolated solitary metastasis, we either start with chemotherapy then re-evaluate for surgery or start by surgery. It is also used if there is evidence of distant metastasis. Most of the chemotherapy being designed is 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".