Aggressive treatment of intrathoracic recurrences of thymoma

Radiother Oncol. 1992 Aug;24(4):221-5. doi: 10.1016/0167-8140(92)90227-l.


Between 1974 and 1988, 21 patients with intrathoracic recurrences of thymoma received radiotherapy with radical intent; surgery was always attempted when considered feasible: 11 patients were partially (6 cases) or totally (5 cases) resected before irradiation, while in the other 10 radiotherapy was the only treatment. In 7 cases the recurrence was confined to the anterior mediastinum, 9 had pleural nodules without mediastinal lesions and 5 had both mediastinal and pleural lesions. Mediastinal recurrences were treated by opposed parallel mediastinal fields with 2/3 of the dose delivered through the anterior port: doses ranged between 38 and 44 Gy; a boost of 10-16 Gy was given in patients not radically resected. Pleural nodules were treated with a variety of techniques according to the extent of the lesions. The 7-year survival of the whole group was 70%; 5 patients died: 4 with intrathoracic progression and one with distant metastases. The survival was 74% in the 11 patients having received surgery, either radical or subtotal, and 65% in the 10 patients treated with radiotherapy alone: the difference is not significant. Patients with Karnofsky index greater than 70 had a significantly better survival (100%, versus 28%, p = 0.0015). This is a selected series of patients presenting recurrences still amenable to a radical treatment either by surgery and radiotherapy or by radiotherapy alone: the results confirm that an aggressive approach is warranted in patients in good general conditions with recurrences confined to the mediastinum and/or 1 hemithorax.

MeSH terms

  • Adult
  • Aged
  • Cobalt Radioisotopes / therapeutic use
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mediastinal Neoplasms / radiotherapy
  • Mediastinal Neoplasms / surgery
  • Middle Aged
  • Neoplasm Recurrence, Local / radiotherapy*
  • Neoplasm Recurrence, Local / surgery*
  • Pleural Neoplasms / radiotherapy
  • Pleural Neoplasms / surgery
  • Radiotherapy, High-Energy
  • Survival Rate
  • Thymoma / radiotherapy*
  • Thymoma / surgery*
  • Thymus Neoplasms / radiotherapy*
  • Thymus Neoplasms / surgery*
  • Treatment Outcome


  • Cobalt Radioisotopes