胸腺瘤完整切除术后辅助放疗不提高总体生存率

Adjuvant radiotherapy after complete resection of thymoma does not improve the overall survival

目的:评估胸腺瘤完整切除术后辅助放疗与预后的关系。方法:对2001年6月—2008年12月153例接受胸腺瘤完整切除的患者进行回顾性分析和随访。153例患者中,82例接受了中位剂量为50 Gy的术后辅助放疗。根据不同Masaoka分期和2004年WHO组织病理学分型,比较接受和未接受术后辅助放疗患者的5年生存率。结果:接受和未接受术后辅助放疗患者的5年生存率分别为92%和89%,差异无统计学意义(P=0.756)。根据不同的Masaoka分期和2004年WHO组织病理学分型,接受和未接受术后辅助放疗患者的5年生存率差异均无统计学意义(P>0.05)。多因素分析结果显示,仅Masaoka分期是预后的独立相关因素(P=0.001),而WHO组织病理学分型、重症肌无力和术后辅助放疗均与预后无关(P>0.05)。结论:完整手术切除胸腺瘤联合术后辅助放疗与单纯手术相比,并不提高患者的远期生存率。

Objective： To evaluate the relationship between adjuvant radiotherapy after complete resection of thymoma and the overall survival. Methods： A retrospective analysis and follow-up were performed in 153 patients receiving complete resection of thymoma between June 2001 and December 2008. Of the 153 patients, 82 received adjuvant radiotherapy with a median dose of 50 Gy after complete resection of thymoma. The 5-year survival rate was compared between adjuvant radiotherapy group and no-adjuvant radiotherapy group by different Masaoka stages and 2004 WHO histological types. Results： The 5-year survival rates of patients receiving and not receiving adjuvant radiotherapy were 92% and 89%, respectively （P = 0.756）. The 5-year survival rates between the patients receiving and not receiving adjuvant radiotherapy by different Masaoka stages and 2004 WHO histological types were all not significantly different （P 〉 0.05）. The multivariate analysis revealed that Masaoka stage was an independent prognostic factor （P = 0.001）, but the 2004 WHO histological type, myasthenia gravis and postoperative adjuvant radiotherapy were not statistically significant （P 〉 0.05）. Conclusion： As compared with single complete resection of thymoma, adjuvant radiotherapy after complete resection of thymoma can not improve the overall survival.