Radiation Therapy in Thymoma
Résumé
Thymic epithelial tumors (TETs) are rare intrathoracic malignancies, which may be aggressive and difficult to treat (J Thorac Oncol 4: 119–126, 2009; Ann Oncol 26(Suppl 5): v40–55, 2015). TETs are classified according to the World Health Organization (WHO) histopathologic classification, which distinguishes thymomas from thymic carcinomas. The treatment strategy for TETs primarily relies on the surgical resection of the tumor, which represents the most significant prognostic factor on survival.Given the tendency of TETs toward local and regional recurrence, and an established radiosensitivity, radiotherapy is a key component in the treatment strategy, either in the perioperative setting, mostly as postoperative therapy, or as definitive, exclusive treatment in patients not eligible to surgery, usually after primary chemotherapy. Unfortunately, the rarity of TETs, and the lack of prospective, randomized trials, makes it difficult to draw high-level evidence-based recommendations in those different clinical settings. Still, large databases have been analyzed, and guidelines have been established, providing clinicians with algorithms to help the decision-making for radiotherapy in patients with TETs.