The Challenges of Managing Thymic Cancers

An Expert Interview With James Huang, MD, and Gregory J. Riely, MD, PhD

Shira Berman; James Huang, MD; Gregory J. Riely, MD, PhD

Disclosures

May 11, 2012

In This Article

Is Adjuvant Radiation Appropriate?

Medscape: This brings us to another area that's been questioned: Are there clear standards for when one should consider adjuvant radiation therapy?

Dr. Riely: It's not a resolved issue. Because randomized clinical trials have not addressed this question, the best data we have are from retrospective series from single institutions or retrospective series that combine patients from many different institutions.

When we look at all of these data, it becomes relatively clear that patients with stage II thymomas who have had a complete resection don't get a significant benefit from radiation therapy. The same is probably true of stage III tumors, but there's room for disagreement there.[6] However, for any patient who has a positive margin, there is a general recommendation that adjuvant radiation therapy is appropriate.[7]

Dr. Huang: I agree. There's the least amount of disagreement or controversy over the use of radiation therapy for patients with positive margins or residual disease.

For patients with stage II or stage III disease who have been completely resected and have no residual disease, the jury is still out on whether it is worth giving adjuvant radiation therapy as a prophylactic measure. Although the custom has been to offer it in this setting, more and more people are questioning it.

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