ArticleJournal of thoracic disease2025
Analysis of efficacy and safety of intensity-modulated radiotherapy with "Target-Ring" strategy for stage IVA large-volume thymoma and thymic carcinoma: a single-center study.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Thymic tumors at stage IVA are characterized by local invasion into adjacent structures (e.g., pericardium, great vessels) and/or regional lymph node metastasis, with unresectable large-volume tumors posing unique therapeutic challenges due to their proximity to critical thoracic organs and potential for high tumor burden. Additionally, previous studies have shown that conventional radiotherapy for advanced thymic malignancies may be limited by dose constraints to normal tissues, highlighting the need to assess the role of intensity-modulated radiotherapy (IMRT) in optimizing therapeutic ratios. This study aimed to evaluate the efficacy and safety of IMRT in treating unresectable large-volume thymic tumors at stage IVA. Methods: A retrospective analysis was conducted on 13 patients with unresectable large-volume stage IVA thymic tumors treated between January 2010 and June 2018. All patients received radical IMRT using the "Target-Ring" dose escalation strategy, with prescribed doses of 50 Gy to the planning target volume (PTV), 60 Gy to the clinical target volume (CTV), and 70 Gy to the gross tumor volume (GTV) delivered in 15-20 fractions. Outcomes including objective response rate (ORR), disease control rate (DCR), local progression-free survival (LPFS), overall survival (OS), and adverse reactions were analyzed. Results: The median follow-up was 82 months (range, 13-145 months). The ORR was 84.6% (11/13), and the DCR was 100% (13/13). The 1-, 3-, 5-, and 8-year OS rates were 100%, 69.2%, 61.5%, and 39.6%, respectively, while the corresponding LPFS rates were 100%, 69.2%, 59.3%, and 37.1%. Only one patient experienced grade 3 hematologic toxicity; no grade ≥3 non-hematologic toxicities were observed. Seven patients died of cancer-related progression. Conclusions: IMRT with the "Target-Ring" strategy demonstrates favorable efficacy and safety for unresectable large-volume stage IVA thymic tumors, offering a viable non-surgical treatment option.
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