Esra Korkmaz Kıraklı, Hasan Yılmaz, Sevilay Erdem, Mediha Tülin Bozkurt

Masaoka evre II ve III timomada radyoterapinin rolü - tek merkez deneyimi

Amaç: Timomalar oldukça nadir tümörlerdir. Tam rezeksiyon tedavinin ana öğesidir. Adjuvan radyoterapinin (RT) rolü Masaoka evre II hastalıkta tartışmalıyken, daha ileri evrelerde ve inoperabl olgularda nettir. Bu çalışma, evre II-III timoma olgularında adjuvan veya radikal RT sonrası lokal kontrol, yinelemesiz sağ kalım ve genel sağ kalım (GS) sonuçlarını araştırmak için planlandı. Gereç ve Yöntem: Ocak 2010-Ağustos 2016 arasında timoma tanısıyla RT uygulanan olguların medikal verileri geriye dönük olarak incelendi. Bulgular: Adjuvan RT uygulanan 18 ve radikal RT uygulanan 5, toplam 23 evre II-III olgu analizlere dahil edildi. Ortanca yaş 59 (50-62) idi. Opere olguların tümünde rezeksiyon R0 şeklindeydi. Adjuvan RT dozu 50 Gy, radikal RT dozu 60-66 Gy idi. En sık izlenen toksisite 9 olguda (%39) gelişen derece 1 pnömoni idi. Derece 2 pnömoni 3 olguda (%13), derece 2 özofajit 2 olguda (%9) izlenirken, 1 olguda geç dönem özofajial toksisite izlendi. İzlem süresi ortanca 18 aydı (6-99 ay). Lokal kontrol oranı %100, yinelemesiz sağ kalım oranı %96, kansere özgü sağ kalım %96, 2 yıllık GS oranı %83’tü. Sonuç: Sonuçlarımız literatür ile uyumlu görünmesine rağmen, timomanın yineleme oranı düşük ve yinelemesiz sağ kalımı uzun bir hastalık olması nedeniyle lokal kontrol, yinelemesiz sağ kalım ve GS sonuçlarımızla ilgili yorum yapabilmemiz için daha uzun izlem süresine ihtiyaç duyulmaktadır.

Role of radiotherapy in Masaoka stage II and III thymomas – single center experience

Aim: Thymomas are rare neoplasms. Complete surgical resection is the cornerstone of the treatment.The role of adjuvant radiotherapy (RT) in Masaoka stage II disease is controversial, but in more advancedstages and the role of radical RT in inoperable cases are clear. This study is conducted to evaluate localcontrol, relapse free survival and overall survival rates in Masaoka stage II and III thymoma patients afteradjuvant or radical RT.Materials and Methods: The medical records of thymoma patients who were treated and completed theirRT course between January 2010 and August 2016 in a single center were evaluated retrospectively.Results: Twenty-two patients were available for analysis. Treatment planning was adjuvant in 18 patientsand radical in 5 patients. Median age at diagnosis was 59 (50-62). Type of resection was R0 in all cases.The adjuvant RT dose was 50 Gy; radical RT dose was 60-66 Gy. The most common acute toxicity wasgrade 1 pneumonitis which was reported in 9 patients (39%). Grade 2 acute pneumonitis wasexperienced by 3 patients (13%), grade 2 acute esophagitis was experienced by 2 patients (9%). Onepatient had late grade 3 esophageal toxicity. Follow-up time ranged from 6 to 99 months, median 18months, local control rate was 100%, relapse free survival (RFS) was 96%, cancer specific survival was96%, 2 years overall survival (OS) was 83%.Conclusion: Although our results seem to be in concordance with the literature, longer follow-up isneeded to be able to make a conclusion in terms of LC, RFS and OS, since thymoma has an indolentcourse with low relapse rate and long RFS.

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