Effect of preoperative concurrent chemo-radiotherapy for thymic carcinoma

Ten cases of thymic carcinoma were operated in our hospital from 1975 to 2000. Preoperative concurrent chemo-radiotherapy was performed in 3 cases among them according to same protocol. The 3 patients had same poorly differentiated carcinomas. They underwent 2 courses of systemic chemotherapy [cisplatin (CDDP) + etoposide (VP-16)] with concurrent radiotherapy (40 Gy). We had one complete-response, one partial-response and one no-response by the induction therapy. Only the no-responder underwent one more course of chemotherapy [CDDP + gemcitabine (GEM)]. Operations were performed four weeks after the end of the induction therapy. All patients underwent complete resections, but the no-responder needed cardiopulmonary bypass for combined resection of right atrium. Two cases are living without recurrence more than 2 years and half, but the no-responder died from infection (empyema) at 34th postoperative day. Therefore, it was revealed that the induction concurrent chemo-radiotherapy for thymic carcinomas is extremely effective for some patients but invalid for other cases.