Thymoma: Radiation and Chemotherapy

  • Wui-Jin Koh
  • Patrick J. LoehrerSr.
  • Charles R. ThomasJr.
Part of the Medical Radiology book series (MEDRAD)


The initial treatment of choice for all thymomas, with the exception of rare cases presenting with grossly unresectable local disease or diffuse metastases, is complete tumor resection. Surgical considerations are discussed elsewhere in this volume [1]. While various investigators have suggested that histological morphology [2–5] and flow cytometric assessment [6] may have prognostic implications, the primary determinants of clinical outcome are surgicopathologic staging and the related extent of surgical resection [7–10], which then form the basis for selection of adjuvant radiation and/or chemotherapy.


Thymic Carcinoma Resected Stage Masaoka Stage Invasive Thymoma Malignant Thymoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Wilkins EW Jr (1995) Thymoma: surgical management. In: Wood DE, Thomas CR Jr (eds), Medical Radiology. Diagnostic Imaging and Radiation Oncology — Mediastinal Tumors. Springer-Verlag, Heidelberg, pp 11–18Google Scholar
  2. Marino M, Muller-Hermelink HK (1985) Thymoma and thymic carcinoma. Relation of thymoma epithelial cells to the cortical and medullary differentiation of thymus. Virchows Arch [A] Pathol Anat Histopathol 407: 119–149CrossRefGoogle Scholar
  3. Verley JM, Hollmann KH (1985) Thymoma. A comparative study of clinical stages, histologic features, and survival in 200 cases. Cancer 55: 1074–1086PubMedCrossRefGoogle Scholar
  4. Pescarmona E, Rendina EA, Venuta F, et al. (1990) Analysis of prognostic factors and clinicopathological staging of thymoma. Ann Thorac Surg 50: 534–538PubMedCrossRefGoogle Scholar
  5. Quintanilla-Martinez L, Wilkins EW Jr, Ferry JA, Harris NL (1993) Thymoma — morphologic subclassification correlates with invasiveness and immunohistologic features: a study of 122 cases. Hum Pathol 24: 958–969PubMedCrossRefGoogle Scholar
  6. Pollack A, El-Nagger AK, Cox JD, Ro JY, Sahin A, Komaki R (1992) Thymoma. The prognostic significance of flow cytometric DNA analysis. Cancer 69: 1702–1709PubMedCrossRefGoogle Scholar
  7. Nakahara K, Ohno K, Hashimoto J, et al. (1988) Thymoma: results with complete resection and adjuvant postoperative irradiation in 141 consecutive patients. J Thorac Cardiovasc Surg 95: 1041–1047PubMedGoogle Scholar
  8. Wick MR (1990) Assessing the prognosis of thymomas. Ann Thorac Surg 50: 521–522PubMedCrossRefGoogle Scholar
  9. Maggi G, Casadio C, Cavallo A, Cianci R, Molinatti M, Ruffini E (1991) Thymoma: results of 241 operated cases. Ann Thorac Surg 51: 152–156PubMedCrossRefGoogle Scholar
  10. Wilkins EW Jr, Grillo HC, Scannell JG, Moncure AC, Mathisen DJ (1991) Role of staging in prognosis and management of thymoma. Ann Thorac Surg 51: 888–892PubMedCrossRefGoogle Scholar
  11. Bergh NP, Gatzinsky P, Larsson S, Lundin P, Ridell B (1978) Tumors of the thymus and thymic region I. Clinicopathological studies of thymomas. Ann Thorac Surg 25: 91–98PubMedCrossRefGoogle Scholar
  12. Masaoka A, Monden Y, Nakahara K, Tanioka T (1981) Follow-up study of thymomas with special reference to their clinical stages. Cancer 48: 2485–2492PubMedCrossRefGoogle Scholar
  13. Wilkins EW Jr, Castleman B (1979) Thymoma: a continuing survey at the Massachusetts General Hospital. Ann Thorac Surg 28: 252–256PubMedCrossRefGoogle Scholar
  14. Curran WJ Jr, Kornstein MJ, Brooks JJ, Turrisi AT (1988) Invasive thymoma: the role of mediastinal irradiation following complete or incomplete surgical resection. J Clin Oncol 6: 1722–1727PubMedGoogle Scholar
  15. Yamakawa Y, Masaoka A, Hashimoto T, et al. (1991) A tentative tumor-node-metastasis classification of thymoma. Cancer 68: 1983–1987CrossRefGoogle Scholar
  16. Arakawa A, Yasunaga T, Saitoh Y, et al. (1990) Radiation therapy of invasive thymoma. Int J Radiat Oncol Biol Phys 18: 529–534PubMedCrossRefGoogle Scholar
  17. Jackson MA, Ball DL (1991) Post-operative radiotherapy in invasive thymoma. Radiother Oncol 21: 77–82PubMedCrossRefGoogle Scholar
  18. Batata MA, Martini N, Huvos AG, Aguilar RI, Beattie EJ (1974) Thymomas: clinicopathologic features, therapy, and prognosis. Cancer 34: 389–396PubMedCrossRefGoogle Scholar
  19. Nordstrom DG, Tewfik HH, Latourette HB (1979) Thymoma: therapy and prognosis as related to operative staging. Int J Radiat Oncol Biol Phys 5: 2059–2062PubMedCrossRefGoogle Scholar
  20. Appelqvist P, Kostiainen S, Franssila K, Mattila S, Grohn P (1982) Treatment and prognosis of thymoma: a review of 25 cases. J Surg Oncol 20: 265–268PubMedCrossRefGoogle Scholar
  21. Maggi G, Giaccone G, Donadio M, et al. (1986) Thymomas. A review of 169 cases, with particular reference to results of surgical treatment. Cancer 58: 765–776PubMedCrossRefGoogle Scholar
  22. Haniuda M, Morimoto M, Nishimura H, Kobayashi O, Yamanda T, Iida F (1992) Adjuvant radiotherapy after complete resection of thymoma. Ann Thorac Surg 54:311–315PubMedCrossRefGoogle Scholar
  23. Pollack A, Komaki R, Cox JD, et al. (1992) Thymoma: treatment and prognosis. Int J Radiat Oncol Biol Phys 23:1037–1043PubMedCrossRefGoogle Scholar
  24. Etienne T, Deleaval PJ, Spiliopoulos A, Megevand R (1993) Thymoma: prognostic factors. Eur J Cardiothorac Surg 7: 449–452PubMedCrossRefGoogle Scholar
  25. Urgesi A, Monetti U, Rossi G, Ricardi U, Maggi G, Sannazzari GL (1992) Aggressive treatment of intrathoracic recurrences of thymoma. Radiother Oncol 24:221–225PubMedCrossRefGoogle Scholar
  26. Urgesi A, Monetti U, Rossi G, Ricardi U, Casadio C (1990) Role of radiation therapy in locally advanced thymoma. Radiother Oncol 19:273–280PubMedCrossRefGoogle Scholar
  27. Chahinian AP, Bhardwaj S, Meyer RJ, Jaffrey IS, Kirschner PA, Holland JF (1981) Treatment of invasive or metastatic thymoma: report of eleven cases. Cancer 47: 1752–1761PubMedCrossRefGoogle Scholar
  28. Marks RD Jr, Wallace KM, Pettit HS (1978) Radiation therapy control of nine patients with malignant thymoma. Cancer 41: 117–119PubMedCrossRefGoogle Scholar
  29. Monden Y, Nakahara K, Iioka S, et al. (1985) Recurrence of thymoma: clinicopathological features, therapy, and prognosis. Ann Thorac Surg 39: 165–169PubMedCrossRefGoogle Scholar
  30. Penn CRH, Hope-Stone HF (1972) The role of radiotherapy in the management of malignant thymoma. Br J Surg 59: 533–539PubMedCrossRefGoogle Scholar
  31. Ariaratnam LS, Kainicki S, Mincer F, Botstein C (1979) The management of malignant thymoma with radiation therapy. Int J Radiat Oncol Biol Phys 5: 77–80PubMedGoogle Scholar
  32. Arriagada R, Bretel JJ, Caillaud JM, et al. (1984) Invasive carcinoma of the thymus. A multicenter retrospective review of 56 cases. Eur J Cancer Clin Oncol 20: 69–74PubMedCrossRefGoogle Scholar
  33. Cohen DJ, Ronnigen LD, Graeber GM, et al. (1984) Management of patients with malignant thymoma. J Thorac Cardiovasc Surg 87: 301–307PubMedGoogle Scholar
  34. Kersh CR, Eisert DR, Hazra TA (1985) Malignant thymoma: role of radiation therapy in management. Radiology 156:207–209PubMedGoogle Scholar
  35. Krueger JB, Sagerman RH, King GA (1988) Stage III thymoma: results of postoperative radiation therapy. Radiology 168: 855–858PubMedGoogle Scholar
  36. Emami B (1992) Mediastinum and trachea. In: Perez CA, Brady LW (eds) Principles and Practice of Radiation Oncology, 2nd edn. Lippincott, Philadelphia, pp 837–852Google Scholar
  37. Uematsu M, Kondo M (1986) A proposal for treatment of invasive thymoma. Cancer 58: 1979–1984PubMedCrossRefGoogle Scholar
  38. Roach M III, Vijayakumar S (1995) The role of three- dimensional conformal radiotherapy in the treatment of mediastinal tumors. In: Wood DE, Thomas CR Jr (eds) Medical Radiology. Diagnostic Imaging and Radiation Oncology-Mediastinal tumors. Springer-Verlag, Heidelberg, pp 117–123Google Scholar
  39. Loehrer PJ (1993) Thymomas. Current experience and future directions in therapy. Drugs 45: 477–487PubMedCrossRefGoogle Scholar
  40. Bonomi PD, Finkelstein D, Aisner S, Ettinger D (1993) EST 2582 phase II trial of cisplatin in metastatic or recurrent thymoma. Am J Clin Oncol 16: 342–345PubMedCrossRefGoogle Scholar
  41. Harper PG, Highley M, Rankin E, et al. (1991) Ifosfamide monotherapy demonstrates high activity in malignant thymoma. Proc Am Soc Clin Oncol 10: 300 (abstract #1049)Google Scholar
  42. Goldel N, Boning L, Fredrik A, Hozel D, Hartenstein R, Wilmanns W (1989) Chemotherapy of invasive thymoma: a retrospective study of 22 cases. Cancer 63: 1493–1500PubMedCrossRefGoogle Scholar
  43. Hue E, Levine J (1986) Chemotherapy of malignant thymoma: case report and review of the literature. Cancer 57: 1101–1104CrossRefGoogle Scholar
  44. Loehrer PJ, Perez CA, Roth LM, Greco A, Livingston RB, Einhorn LH (1990) Chemotherapy for advanced thymoma: preliminary results of an intergroup study. Ann Intern Med 113: 520–524PubMedGoogle Scholar
  45. Fornasiero A, Daniele O, Ghiotto C, et al. (1991) Chemotherapy for invasive thymoma: a 13-year experience. Cancer 68: 30–33PubMedCrossRefGoogle Scholar
  46. Macchiarini P, Chella A, Ducci F, et al. (1991) Neoadjuvant chemotherapy, surgery, and postoperative radiation therapy for invasive thymoma. Cancer 68: 706–713PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • Wui-Jin Koh
    • 1
  • Patrick J. LoehrerSr.
    • 2
  • Charles R. ThomasJr.
    • 3
  1. 1.Department of Radiation OncologyUniversity of Washington, RC-08SeattleUSA
  2. 2.Section of Hematology and OncologyIndiana University School of MedicineIndianapolisUSA
  3. 3.Department of Radiation OncologyUniversity of Washington Medical Center, RC-08SeattleUSA

Personalised recommendations