Objectives:This multicenter study aimed to clarify the recurrence patterns; treatment outcomes; and prognostic factors of thymic carcinoma, a rare cancer.Methods:We analyzed 101 patients with thymic carcinoma who underwent multidisciplinary treatment, including radiotherapy. The median age was 62 years, with 27 patients in stage I–II; 44 in stage III; and 30 in stage IV by the TNM classification. Seventy-two patients underwent surgery with radiotherapy; and 29 patients underwent definitive radiotherapy. Image-guided radiotherapy (IGRT) and elective nodal irradiation (ENI) were used for 35 and 23 patients, respectively. Local recurrence-free survival (LRFS); progression-free survival (PFS); and overall survival (OS) were calculated, and univariate and multivariate analyses were performed.Results: With a median follow-up of 68 months, we observed 17 local recurrences; 27 regional recurrences; and 35 distant metastases. The 5-year LRFS; PFS; and OS were 82%, 41%, and 76%, respectively. Multivariate analysis revealed that stage was the only factor associated with LRFS; PFS; and OS (p= 0.040;p< 0.0001; andp= 0.048, respectively), while treatment modality was associated with only LRFS (p= 0.015). IGRT and ENI were also associated with LRFS (p= 0.002 and 0.013, respectively). PFS and OS of stage IV patients were comparable between the surgery with radiotherapy and definitive radiotherapy groups (p= 0.99 and 0.98, respectively).Conclusions:Our results suggest the importance of stage-specific treatment strategies rather than resectability, especially for stage IV patients. These results should be validated in a prospective study. Our results also suggest that radiotherapy methods influence recurrence
目的：本研究为多中心研究，旨在阐明罕见肿瘤——胸腺癌的复发模式、治疗结局及预后因素。方法：我们分析了101例接受包括放疗在内的多学科综合治疗的胸腺癌患者。患者中位年龄62岁，根据TNM分期，Ⅰ-Ⅱ期27例，Ⅲ期44例，Ⅳ期30例。72例患者接受手术联合放疗，29例接受根治性放疗。分别有35例和23例患者接受了图像引导放疗（IGRT）和选择性淋巴结照射（ENI）。计算局部无复发生存期（LRFS）、无进展生存期（PFS）和总生存期（OS），并进行单因素及多因素分析。结果：中位随访68个月，观察到局部复发17例，区域复发27例，远处转移35例。5年LRFS、PFS和OS分别为82%、41%和76%。多因素分析显示，分期是唯一与LRFS、PFS和OS均相关的因素（p值分别为0.040、<0.0001和0.048），而治疗方式仅与LRFS相关（p=0.015）。IGRT和ENI也与LRFS相关（p值分别为0.002和0.013）。对于Ⅳ期患者，手术联合放疗组与根治性放疗组的PFS和OS无显著差异（p值分别为0.99和0.98）。结论：我们的结果表明，制定基于分期的治疗策略比单纯考虑可切除性更为重要，尤其对于Ⅳ期患者。此结论需在前瞻性研究中进一步验证。本研究结果也提示放疗技术会影响复发情况。
肿瘤(癌症)患者之家