A prospective, phase II trial of induction chemotherapy with docetaxel/cisplatin for Masaoka stage III/IV thymic epithelial tumors.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7104-7104
Author(s):  
Silvia Park ◽  
Keunchil Park ◽  
Myung-ju Ahn ◽  
Jin Seok Ahn ◽  
Jong-Mu Sun ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Phase Ii ◽  
Thymic Carcinoma ◽  
Locally Advanced ◽  
Complete Resection ◽  
Stage Iii ◽  
Thymic Epithelial Tumors ◽  
Epithelial Tumors ◽  
Masaoka Stage ◽  
Prospective Phase

7104 Background: Thymic epithelial tumors (TETs), thymoma and thymic carcinoma, are the most common tumor of the anterior mediastinum. Initial complete resection is the most powerful prognostic indicator of survival. However, it is obviously related to stage. Here, we report the result of a prospective phase II study of neoadjuvant docetaxel/cisplatin in patients with locally advanced TETs. Methods: In this open-label, phase II, nonrandomized study, patients with histologically proven, Masaoka stage III/IV TETs at presentation were enrolled. Patients received docetaxel 75mg/m2 I.V for 1 hr, followed by I.V cisplatin 75mg/m2 over 1.5hr on day 1 of every 3 week. After 3 cycles of chemotherapy, subsequent surgical resection was performed, if resectable. Results: From March 2007 to July 2011, a total of 27 TETs patients were entered into the trial. The median age was 54 (range, 15-68), and Masaoka stage at presentation was III (n=8, 29.6%), IVA (n=17, 63.0%), and IVB (n=2, 7.4%). Histologic type by the WHO includes type B1 (n=2, 7.4%), B2 (n=3, 11.1%), B3 (n=5, 18.5%), and thymic carcinoma designated as type C (n=16, 59.3%). After completion of neoadjuvant chemotherapy, 17 (63.0%) achieved PR and 10 (37.0%) had SD. Nineteen patients (70.4%) underwent surgical resection, and 8 patients did not (surgeons’ decision, n=5; patients’ refusal, n=2; radiation therapy, n=1). Of the 19 patients undergoing surgical resection, 17 (89.5%) had complete resections and 2 (10.5%) did not. Major side effects of chemotherapy include grade 3 anorexia (n=1), nausea (n=2), diarrhea (n=3), alopecia (n=1). After completion of surgical resection, adjuvant therapy was performed as follows: radiotherapy (RT, n=8), chemotherapy (CTx, n=6), radiotherapy with chemotherapy (RT + CTx, n=2) and observation (n=3). Overall, 4yr OS and PFS was 79.4% and 40.6%. Patients with complete resection showed 93.8% of 4yr OS and 50.2% of 4yr PFS whereas patients without complete resection showed 47.6% of 4yr OS and 26.7% of 4yr PFS, respectively (OS, p=0.06; PFS, p=0.27). Conclusions: Neoadjuvant docetaxel/cisplatin was well tolerated and feasible, and improved the surgical respectability in patients with advanced TETs.

Phase II study of neoadjuvant chemotherapy with modified FOLFOXIRI in borderline resectable or unresectable stage III pancreatic cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4062-4062 ◽  
Author(s):  
Enrico Vasile ◽  
Nelide De Lio ◽  
Carla Cappelli ◽  
Luca Pollina ◽  
Niccola Funel ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Surgical Resection ◽  
Phase Ii ◽  
Locally Advanced ◽  
Local Treatment ◽  
Stage Iii ◽  
Borderline Resectable ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Radical Surgical Resection

4062 Background: FOLFIRINOX has shown high activity in metastatic pancreatic cancer (PC) patients and could be an interesting regimen also for patients with inoperable locally advanced disease. Our group had developed a similar schedule in metastatic colorectal cancer named FOLFOXIRI with good tolerance and activity. Therefore, we have decided to perform a phase II trial to prospectively evaluate the activity of modified FOLFOXIRI in borderline resectable or unresectable PC. Methods: Modified FOLFOXIRI consisted of a lower dose of irinotecan (150 mg/sqm) and of infusional 5-fluorouracil (2800 mg/sqm as a 48-hour continuous infusion on days 1 to 3) with no bolus 5-fluorouracil. Folinic acid and oxaliplatin (85 mg/sqm) remained unchanged. The study enrolled patients with diagnosis of pancreatic adenocarcinoma, stage III borderline resectable or unresectable disease (cT4,cN0-1,cM0), ECOG PS 0-1, age 18-75. The primary end-point of the study was the percent of patients who undergo radical surgical resection after chemotherapy. Results: Thirty-two patients have been enrolled; M/F=12/20; PS 0/1=16/16. Median age was 60 years (range 44-75). Median number of FOLFOXIRI cycles was 6 (range 2-14). Grade 3-4 toxicities was experienced by 20 patients during chemotherapy. Twelve partial responses (37%) and 14 stable diseases (45%) have been observed; 2 patients had progressive diseases (6%). The remaining 4 patients (12%) have not been yet evaluated because are still in the first months of treatment. A local treatment was received after chemotherapy by 18 patients until now: 13 (41%) received radical surgical resection and 5 received concomitant chemo-radiotherapy. Three explorative laparotomy showed occult metastases. In other 7 cases surgery is planned while 2 patients refused surgery. Median progression-free survival is 14.0 months and median overall survival is 24.2 months with a two-year survival rate of 54%. Conclusions: Chemotherapy with FOLFOXIRI seems active in locally advanced PC and may allow to obtain a downstaging of disease leading to achieve a curative surgical resection in some cases. Longer follow up is needed to better evaluate long-term outcome of this strategy.

Analysis of surgical treatment of Masaoka stage III-IV thymic epithelial tumors

2018 ◽  
Vol 66 (12) ◽  
pp. 731-735 ◽  
Author(s):  
Kazutoshi Hamanaka ◽  
Tsutomu Koyama ◽  
Shunichiro Matsuoka ◽  
Tetsu Takeda ◽  
Kentaro Miura ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Stage Iii ◽  
Thymic Epithelial Tumors ◽  
Epithelial Tumors ◽  
Masaoka Stage

scholarly journals Video-assisted thoracoscopy versus open approach in patients with Masaoka stage III thymic epithelial tumors

2019 ◽  
Vol 8 (3) ◽  
pp. 962-967
Author(s):  
Liru Chen ◽  
Chen Xie ◽  
Qing Lin ◽  
Quan Xu ◽  
Yangchun Liu ◽  
...  
Keyword(s):  
Stage Iii ◽  
Open Approach ◽  
Thymic Epithelial Tumors ◽  
Video Assisted ◽  
Epithelial Tumors ◽  
Masaoka Stage

scholarly journals Prognostic Significance of Metabolic Parameters by 18F-FDG PET/CT in Thymic Epithelial Tumors

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 712
Author(s):  
Joohee Lee ◽  
Young Seok Cho ◽  
Jhingook Kim ◽  
Young Mog Shim ◽  
Kyung-Han Lee ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Fdg Pet ◽  
Univariate Analysis ◽  
Thymic Epithelial Tumors ◽  
Epithelial Tumors ◽  
Masaoka Stage ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Background: Imaging tumor FDG avidity could complement prognostic implication in thymic epithelial tumors. We thus investigated the prognostic value of volume-based 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT parameters in thymic epithelial tumors with other clinical prognostic factors. Methods: This is a retrospective study that included 83 patients who were diagnosed with thymic epithelial tumors and underwent pretreatment 18F-FDG PET/CT. PET parameters, including maximum and average standardized uptake values (SUVmax, SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured with a threshold of SUV 2.5. Univariate and multivariate analysis of PET parameters and clinicopathologic variables for time-to-progression was performed by using a Cox proportional hazard regression model. Results: There were 21 low-risk thymomas (25.3%), 27 high-risk thymomas (32.5%), and 35 thymic carcinomas (42.2%). Recurrence or disease progression occurred in 24 patients (28.9%). On univariate analysis, Masaoka stage (p < 0.001); histologic types (p = 0.009); treatment modality (p = 0.001); and SUVmax, SUVavg, MTV, and TLG (all p < 0.001) were significant prognostic factors. SUVavg (p < 0.001) and Masaoka stage (p = 0.001) were independent prognostic factors on multivariate analysis. Conclusion: SUVavg and Masaoka stage are independent prognostic factors in thymic epithelial tumors.

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