From the Guidelines
Thymoma treatment should involve a multidisciplinary approach, and patients should be referred to a thoracic surgeon who specializes in mediastinal tumors, as well as a team of medical oncologists, radiation oncologists, pulmonologists, and neurologists. The primary treatment for thymoma is complete surgical resection of the tumor, which may include thymectomy (removal of the entire thymus gland) 1. For early-stage thymomas (stages I and II), surgery alone may be sufficient. For more advanced disease (stages III and IV), a combination of treatments including surgery, radiation therapy, and chemotherapy may be necessary.
Key Considerations
- The choice of treatment depends on the extent of resection, with complete resection being the gold standard for most resectable tumors 1.
- Chemotherapy regimens such as cisplatin-based combinations (e.g., CAP or PE) may be used, typically administered for 4-6 cycles 1.
- Radiation therapy may be given at doses of 45-60 Gy, particularly for incompletely resected tumors or advanced disease.
- A multidisciplinary team approach is crucial, as thymomas can be associated with paraneoplastic syndromes and may require specialized care beyond just treating the tumor itself.
Specialist Referral
- Patients should be referred to a thoracic surgeon who specializes in mediastinal tumors.
- Additional specialists, including medical oncologists, radiation oncologists, pulmonologists, and neurologists, should be involved in the patient's care, particularly if myasthenia gravis is present 1.
From the Research
Thymoma Treatment
- Thymoma is a type of tumor that can be treated with surgical complete resection, which is the most reliable option for clinical treatment 2.
- Induction chemotherapy followed by surgery is recommended when en bloc resection is considered to be difficult based on evaluation with preoperative modalities 2.
- Volume reduction surgery has been reported to extend prognosis when pleural dissemination is revealed during pre- or peri-operative procedures 2.
- Minimally invasive surgical procedures, such as video-assisted thoracic surgery (VATS) or robotic-assisted thoracic surgery (RATS), can be used for small-sized tumors 2.
Chemotherapy for Thymoma
- Cisplatin, doxorubicin, and methylprednisolone (CAMP) therapy has been shown to be effective for invasive thymoma, with a response rate of 92.9% 3.
- Multidisciplinary treatment with CAMP therapy, surgery, and radiotherapy can bring about good disease control in the majority of patients with advanced invasive thymoma 3.
- Cisplatin-anthracycline (CAP or ADOC) or cisplatin-etoposide combinations are recommended as first-line chemotherapy for thymoma or thymic carcinoma 4.
- Intensive chemotherapy with cisplatin, doxorubicin, cyclophosphamide, etoposide, and granulocyte colony-stimulating factor (G-CSF) has been shown to produce objective remissions in patients with advanced thymoma or thymic cancer 5.