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Abstract：
Pleural dissemination is a common pattern of failure after initial treatment of thymoma and thymic carcinoma, but there is no standardized treatment. As these tumors are relatively radiosensitive, we investigated the effectiveness of radiotherapy. Twenty patients underwent 33 series of local radiotherapy for 96 pleural dissemination lesions after initial treatment. Conventional radiotherapy (CRT), tomotherapy, and combination of the two were employed in 19, 13, and 1 series, respectively. The median follow-up period after the first irradiation for pleural dissemination was 46 months (range, 14-161). For all 20 patients, overall survival (OS) rates from initial radiotherapy for pleural dissemination were 100% at three years and 86% at five years. Progression-free survival (PFS) rates after 33 series of radiotherapy were 30% at three years and 16% at five years. Local control (LC) rates for 96 lesions were 98% at three years and 96% at five years. In-field recurrence was observed in only two among the 96 lesions. One patient (5%) developed grade 3 radiation pneumonitis and another (5%) developed grade 3 pericardial effusion. No other serious adverse events were observed. When disseminated nodules can be covered within localized fields, local radiotherapy may be a treatment option. Using tomotherapy, multiple lesions can be treated safely.
摘要：
胸膜播散是胸腺瘤和胸腺癌初始治疗后失败的常见模式，但是没有标准化的治疗方法。由于这些肿瘤对辐射相对敏感，我们调查了放疗的有效性。初始治疗后，20例患者接受了33次局部放疗，治疗了96个胸膜播散性病变。常规放射治疗（CRT），断层治疗,两者的组合用于19、13和1系列，分别。首次照射胸膜播散后的中位随访期为46个月（范围，14-161).对于所有20名患者来说，胸膜播散初始放疗后的总生存率(OS)为3年100%,5年86%.33系列放疗后的无进展生存率（PFS）为3年30％，5年16％。96个病变的局部控制率（LC）三年为98％，五年为96％。在96个病变中，仅有两个出现了现场复发。一名患者（5％）发生3级放射性肺炎，另一名患者（5％）发生3级心包积液。没有观察到其他严重不良事件。如果可以在局部视野中覆盖播散的结节，局部放疗可能是一种治疗选择。使用断层疗法，多发性病变可以安全治疗。
