36例浸润型胸腺瘤远期疗效分析

LONG TERM EFFECTIVENESS OF DIFFERENT TREATMENTS FOR 36 PATIENTS WITH INVASIVE THYMOMA

目的：通过对浸润型胸腺瘤远期疗效的观察，分析不同的治疗方法与生存率及复发率的关系。方法：将我科１９８６年１０月～１９９２年４月收治的３６例浸润型胸腺瘤病例，根据不同的治疗方法分成３组。Ａ组为姑息手术＋术后放疗，Ｂ组为根治手术＋术后放疗，Ｃ组为姑息手术＋术后放疗＋化疗。放疗方法为多野等中心照射，靶区剂量为４０Ｇｙ～７０Ｇｙ。化疗药物为环磷酰胺、阿霉素、长春新碱、顺铂、丝裂霉素等。结果：５ａ生存率Ａ组３０％，Ｂ组６３％，Ｃ组为６０％。复发率Ａ组为５０％，Ｂ组９％，Ｃ组２０％。结论：对于浸润型胸腺瘤，手术＋术后放疗为有效的治疗方法；对于无法彻底切除的病例，合并化疗可提高生存率，降低复发率。

Objective: To analyze retrospectively the therapeutic effect of invasive thymoma by three kinds of treatment.Methods:36 patients with invasive thymoma were treated from October 1986 to April 1992.They were divided into 3 groups according to the treatment methods they received.Group A:palliative resection + postoperative radiotherapy;Group B:radical resection + postoperative radiotherapy;Group C:palliative resection + postoperative radiotherapy and chemotherapy.The technique of radiotherapy was multifield isocentral irradiation.The dosage of target areas was 40 70 Gy.The drugs used in chemotherapy were CTX,ADM,VCR,DDP and MMC.Results:The survival rates at the 5 th year were A 30%,B 63% and C 60%.The recurrence rates were A 50%,B 9% and C 20%.Conclusion:Resection + postoperative radiotherapy is an effective treatment for invasive thymoma.For those cases that cannot be resected completely,combining with chemotherapy will increase survival rate and decrease recurrence rate.