The Value Of Adjuvant Radiotherapy Ii Of Thymoma

Purpose:To evaluate the benefits of 107 patients with stageⅡthymoma from adjuvant radiotherapy.Material and Methods:From September 1964 to October 2006,107 patients with stageⅡthymoma after complete resection were analysed retrospectively.Sixty-six patients were administrated radiotherapy,44 with conventional radiotherapy and 22 with 3-D conformal radiotherapy.The median dose is 60 Gy(from 22-60Gy). There were no differences in clinical characteristics between S+R group(surgery added radiotherapy) and surgery alone group(S alone),except the stages and histologic types.There were more patients withⅡb stage and with epithelial type (or B3 type in WHO histologic classification) in S+R group(P=0.012 and P=0.023, respectively) than S alone group.Results:There were 93.8%,84.4%and 72.1%of 5,10 and 15 years overall survival rates,94.5%,87.7%and 87.7%of 5,10 and 15 years disease-free survival rates, and 95.9%,90.1%and 90.1%of 5,10 and 15 years disease-specific survival rates respectively.The total recurrence rate was 7.5%,9.5%in S+R group and 4.5%in S alone group.There were 92.3%,82.6%of 5- and 10-year disease-free survival rate in S+R group and 97.6%,93.1%in S alone group(P=0.265),96.4%,89.3%of 5- and 10-year disease-specific survival rate in S+R group 95.3%,91.0%in S alone group (P=0.973),respectively.Compared with the doses of＞50Gy and≤50Gy,there were no statistic differences in survival rates(P=0.62).5- and 10-year disease-free survival rate were higher with tumor bed irradiated than with extended radiation field(94.2%,85.6%VS.83.3%,62.5%),but there were no statistics difference (P=0.098).Twenty-two patients with 3D-CRT were all alive with no recurrence during 5 years and had low complications.There were lower disease-free survival rate with epithelial type than other subtypes(P=0.001).In multivariate analysis,pathologic type was the only prognosis factor.Conclusion:Adjuvant radiotherapy may not be recommended for the patients with stageⅡthymoma after completed resection,except those cases with high risks of recurrence.Instead of whole mediastinum radiotherapy,it may be more suitable for local field and the dose of 50Gy.There were lower the complication and higher survival rates with utilities of 3D-CRT.Furthermore,it is important to estimate the potential benefits of 3D-CRT in randomize clinical trial,especially in the aspects of survival and local control of both primary and recurrent patients.