Treatment of invasive thymoma

Twenty-seven cases with invasive thymoma were treated with surgery and/or radiotherapy. Twenty-six of them consisted of 9 stage II, 11 stage III and 6 stage IV a tumors by Masaoka's classification, while remaining one had recurrent tumors. All cases of stage II were treated with resection only; and there has been no recurrence of tumors. Among stage III patients, all 4 patients treated with local irradiation and 2 of 3 treated with only resection were deceased from the recurrence of tumors. The remaining 4 stage III patients were treated with entire hemithorax irradiation after resection, all of whom are alive and free from relapse for 13 to 81 months. Two stage IV a patients treated with entire hemithorax irradiation of 20 Gy suffered from recurrent pulmonary infections secondary to irradiation pneumonitis. In 2 of stage IV a cases and relapsing one, intensive chemotherapy (CHOP) before radiotherapy up to 15 Gy including entire hemithorax was performed, which proved quite recommendable because all 3 patients are alive and well with no pulmonary complications or relapse for 9 to 15 months.