ABSTRACT
OBJECTIVE: The role of chemotherapy in treating advanced thymic carcinoma is unclear. The purpose of the current study was to investigate the efficacy of chemotherapy and the prognostic factors for patients with advanced thymic carcinoma. METHODS: A retrospective review of the medical records of 86 patients treated with chemotherapy for advanced thymic carcinoma was conducted between 2000 and 2012 at our institution. The clinical characteristics, chemotherapy regimens and prognostic factors were analyzed. Survival curves were plotted using the Kaplan-Meier method and the Cox proportional hazard model was used for multivariate analysis. RESULTS: Of the 86 patients, 56 were male and 30 were female. The median survival time was 24.5 months. For the first-line chemotherapy treatment, the objective response rate was 47.7% and the disease control rate was 80.2%. The median progression-free survival for all patients was 6.5 months for first-line chemotherapy. No significant differences in progression-free survival were observed among the different chemotherapy regimens. Multivariate analyses revealed that the prognostic factors for overall survival included performance status (p=0.043), histology grade (p=0.048), and liver metastasis (p=0.047). CONCLUSION: Our results suggest that there is no difference in efficacy between multiagent and doublet regimens. The prognosis of patients with advanced thymic carcinoma can be predicted based on histological grade, liver metastasis and performance status.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Agents/therapeutic use , Thymoma/drug therapy , Thymus Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Kaplan-Meier Estimate , Liver Neoplasms/secondary , Prognosis , Retrospective Studies , Time Factors , Treatment Outcome , Thymoma/mortality , Thymoma/pathology , Thymus Neoplasms/mortality , Thymus Neoplasms/pathologyABSTRACT
A malignant tumor is generally believed to be very unlikely to metastasize to the thymus. Only three cases of thymic metastases have been reported so far in the medical literature. We report here a rare case of metastatic breast cancer to the thymus, which was detected by CT and PET scanning, and the metastasis was also confirmed by video-assisted thoracic surgery biopsy. Recognition of an unusual breast cancer metastasis, such as to the thymus, as well as the usual patterns of breast cancer metastasis will facilitate an accurate, prompt diagnosis and its appropriate treatment.
Subject(s)
Adult , Female , Humans , Antineoplastic Agents, Phytogenic/therapeutic use , Breast Neoplasms/drug therapy , Carcinoma, Ductal, Breast/drug therapy , Paclitaxel/therapeutic use , Thymus Neoplasms/drug therapyABSTRACT
Invasive thymomas comprise 0.1%-0.2% of all malignancies in India. This report is an audit of 11 cases (10 males and 1 female) at a mean age of 36.6 years (range 25-52 years) of invasive thymoma accrued over an eight year period treated by combined modality treatment. Nine of these presented with myaesthenia gravis. All patients underwent initial surgery (3 partial and 8 total resections) and postoperative radiotherapy. Two of the three partially resected patients received one course of chemotherapy prior to radiotherapy consisting of cyclophosphamide, vincristine, procarbazine and prednisolone. At a median follow up of 28 months (range 2-87) there have been no local relapses, one distant metastasis and one death due to uncontrolled myaesthenia. The treatment strategies with invasive thymomas would depend upon the extent of resection. Postoperative radiotherapy appears to be indicated in all cases, however the role of chemotherapy may be limited to those with partial resection.
Subject(s)
Adult , Antineoplastic Agents/administration & dosage , Antineoplastic Agents, Alkylating/administration & dosage , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cause of Death , Cobalt Radioisotopes/therapeutic use , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Female , Follow-Up Studies , Humans , India , Male , Medical Audit , Middle Aged , Myasthenia Gravis/etiology , Neoplasm Invasiveness , Prednisolone/administration & dosage , Procarbazine/administration & dosage , Radiopharmaceuticals/therapeutic use , Thymectomy , Thymoma/drug therapy , Thymus Neoplasms/drug therapy , Vincristine/administration & dosageABSTRACT
In this study the effect of the alkylating agent, sulfur mustard, on calf thymus chromatin was investigated using UV/V is spectroscopy, gel electrophoresis and thermal denaturation techniques. The results show that treatment of isolated chromatin with sulfur mustard releases histones from the core particles but does not affect histone H1and nonhistone chromosomal proteins. The content of released proteins for the amounts lower than 50ug/ml are both dose and time dependent. It is suggested that they have cross linked reaction to other chromosomal proteins or to DNA. Thermal melting analysis also indicate that the interaction of sulfur mustard with DNA increases thermal melt[TM] of DNA revealing condensation of DNA molecule by sulfur mustard. The results in relation to the functional states of chromatin are discussed