The safety and efficacy of Cyberknife® for thymic malignancy

Cai, Xu; Sun, Jingyan; Zhang, W.; Wang, J.

doi:10.1016/j.canrad.2020.06.026

Cited by 2 publications

(3 citation statements)

References 33 publications

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“…There are multiple factors that may render Masaoka stage III locally advanced thymic carcinomas unresectable, such as phrenic nerve involvement, extensive great vessel invasion, and medical comorbidities. In such circumstances where surgery is not possible, there was panel consensus that curative-intent definitive combined modality therapy with chemoradiation should be pursued based on several studies, with roughly a 50% response rate …”

Section: Resultsmentioning

confidence: 99%

“…In such circumstances where surgery is not possible, there was panel consensus that curative-intent definitive combined modality therapy with chemoradiation should be pursued based on several studies, with roughly a 50% response rate. 28,[32][33][34][35][85][86][87][88][89] The panel evaluated the appropriateness of several aspects of radiation technique for locally advanced thymic carcinoma. The panel recommended against the use of elective nodal radiation therapy, as a retrospective analysis did not demonstrate benefit.…”

Section: Variant 4: Unresectable Locally Advanced Thymic Carcinomamentioning

confidence: 99%

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American Radium Society Appropriate Use Criteria for Radiation Therapy in the Multidisciplinary Management of Thymic Carcinoma

et al. 2023

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ImportanceThymic carcinoma is rare, and its oncologic management is controversial due to a paucity of prospective data. For this reason, multidisciplinary consensus guidelines are crucial to guide oncologic management.ObjectiveTo develop expert multidisciplinary consensus guidelines on the management of common presentations of thymic carcinoma.Evidence ReviewCase variants spanning the spectrum of stage I to IV thymic carcinoma were developed by the 15-member multidisciplinary American Radium Society (ARS) Thoracic Appropriate Use Criteria (AUC) expert panel to address management controversies. A comprehensive review of the English-language medical literature from 1980 to 2021 was performed to inform consensus guidelines. Variants and procedures were evaluated by the panel using modified Delphi methodology. Agreement/consensus was defined as less than or equal to 3 rating points from median. Consensus recommendations were then approved by the ARS Executive Committee and subject to public comment per established ARS procedures.FindingsThe ARS Thoracic AUC panel identified 89 relevant references and obtained consensus for all procedures evaluated for thymic carcinoma. Minimally invasive thymectomy was rated as usually inappropriate (regardless of stage) due to the infiltrative nature of thymic carcinomas. There was consensus that conventionally fractionated radiation (1.8-2 Gy daily) to a dose of 45 to 60 Gy adjuvantly and 60 to 66 Gy in the definitive setting is appropriate and that elective nodal irradiation is inappropriate. For radiation technique, the panel recommended use of intensity-modulated radiation therapy or proton therapy (rather than 3-dimensional conformal radiotherapy) to reduce radiation exposure to the heart and lungs.Conclusions and RelevanceThe ARS Thoracic AUC panel has developed multidisciplinary consensus guidelines for various presentations of thymic carcinoma, perhaps the most well referenced on the topic.

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Section: Resultsmentioning

confidence: 99%

Section: Variant 4: Unresectable Locally Advanced Thymic Carcinomamentioning

confidence: 99%

American Radium Society Appropriate Use Criteria for Radiation Therapy in the Multidisciplinary Management of Thymic Carcinoma

et al. 2023

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“…Abscopal effects after RT for TETs have been reported, suggesting possible RT immunomodulation in the microenvironment ( 18 , 19 ). Notably, one abscopal case report followed the use of CyberKnife stereotactic radiotherapy ( 20 ). In this context, heavy-ion RT is of particular interest.…”

Section: Expectations On Hadrontherapy For Thymic Epithelial Tumorsmentioning

confidence: 99%

Hadrontherapy for Thymic Epithelial Tumors: Implementation in Clinical Practice

et al. 2021

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Radiation therapy is part of recommendations in the adjuvant settings for advanced stage or as exclusive treatment in unresectable thymic epithelial tumors (TETs). However, first-generation techniques delivered substantial radiation doses to critical organs at risk (OARs), such as the heart or the lungs, resulting in noticeable radiation-induced toxicity. Treatment techniques have significantly evolved for TET irradiation, and modern techniques efficiently spare normal surrounding tissues without negative impact on tumor coverage and consequently local control or patient survival. Considering its dosimetric advantages, hadrontherapy (which includes proton therapy and carbon ion therapy) has proved to be worthwhile for TET irradiation in particular for challenging clinical situations such as cardiac tumoral involvement. However, clinical experience for hadrontherapy is still limited and mainly relies on small-size proton therapy studies. This critical review aims to analyze the current status of hadrontherapy for TET irradiation to implement it at a larger scale.

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The safety and efficacy of Cyberknife® for thymic malignancy

Cited by 2 publications

References 33 publications

American Radium Society Appropriate Use Criteria for Radiation Therapy in the Multidisciplinary Management of Thymic Carcinoma

American Radium Society Appropriate Use Criteria for Radiation Therapy in the Multidisciplinary Management of Thymic Carcinoma

Hadrontherapy for Thymic Epithelial Tumors: Implementation in Clinical Practice

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