A phase II trial of dose-dense chemotherapy, followed by surgical resection and/or thoracic radiotherapy, in locally advanced thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9606)

作者：Kunitoh H^*; Tamura T; Shibata T; Takeda K; Katakami N; Nakagawa K; Yokoyama A; Nishiwaki Y; Noda K; Watanabe K; Saijo N

来源：British Journal of Cancer, 2010, 103(1): 6-11.

DOI：10.1038/sj.bjc.6605731

• chemotherapy
• dose-dense
• radiotherapy
• surgical resection
• thymoma
• unresectable

BACKGROUND: This study aimed to evaluate the safety and efficacy of dose-dense weekly chemotherapy, followed by resection and/or thoracic radiotherapy.
METHODS: Patients with histologically documented thymoma with unresectable stage III disease received 9 weeks of chemotherapy: cisplatin 25 mgm(-2) on weeks 1-9; vincristine 1 mgm(-2) on weeks 1, 2, 4, 6 and 8; and doxorubicin 40 mgm(-2) and etoposide 80 mgm(-2) on days 1-3 of weeks 1, 3, 5, 7 and 9. Patients went on to surgery and post-operative radiotherapy of 48 Gy; those with unresectable disease received 60 Gy radiotherapy.
RESULTS: A total of 23 patients were entered. The main toxicities of the chemotherapy regimen were neutropenia and anaemia, and 57% of patients completed the planned 9 weeks of therapy. There were no toxic deaths. Of the 21 eligible patients, 13 (62%) achieved a partial response (95% confidence interval: 38-82%). Thirteen patients underwent a thoracotomy and nine (39%) underwent complete resection. Progression-free survival at 2 and 5 years was 80 and 43%, respectively. Overall survival at 5 and 8 years was 85 and 69%, respectively. Survival did not seem to be affected by resection.
CONCLUSION: In thymoma patients, weekly dose-dense chemotherapy has activity similar to that of conventional regimens. Although some patients could achieve complete resection, the role of surgery remains unclear. British Journal of Cancer (2010) 103, 6-11. doi:10.1038/sj.bjc.6605731 www.bjcancer.

• 出版日期2010-6-29