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The role of postoperative radiation therapy for completely resected stage III thymoma and effect of higher heart radiation dose on risk of cardiovascular disease: A retrospective cohort study.
Int J Surg. 2018 Apr 16;:
Authors: Liao J, Liu T, Zhang H, Cai F, Chen J, Dang J
Abstract
OBJECTIVES: This study aimed to assess the efficacy of radiation therapy (RT) in patients with completely resected stage III thymoma and evaluate the relationship between higher heart dose and risk of cardiovascular disease (CVD).
PATIENTS AND METHODS: A total of 130 consecutive patients with Masaoka stage III thymoma were retrospectively reviewed from January 2003 to December 2013. Of these, 99 underwent complete tumor resection [74 received postoperative radiation therapy (S + R) and 25 received surgery alone (S alone)] and 31 patients underwent RT alone (16 due to inoperable tumors and 15 due to high surgical risk or patient refusal; R alone). Three-dimensional conformal RT/intensity-modulated RT was used for patients receiving RT.
RESULTS: The median follow-up for all patients was 70 months. The 5- and 8-year overall survival (OS) rates were 95.6% and 93.9% for S + R, 84.0% and 67.2% for S alone, and 73.3% and 73.3% for R alone (excluding patients with inoperable tumors), respectively (P = 0.004). A trend of improved disease-specific survival (DSS) was also observed in the S + R group compared with the other two groups. CVD was the main nonmalignant cause of death (3/6, 50%). The median time of CVD diagnosis was 101 months after treatment. The mean heart dose was an independent risk factor for CVD.
CONCLUSIONS: Postoperative RT after complete resection improved the survival compared with surgery alone and RT alone for patients with stage III thymoma. A higher heart dose was related to increased risk of CVD in long-term survivors.
PMID: 29673690 [PubMed - as supplied by publisher]
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