Prognosis of Concurrent Versus Sequential Chemo-Radiotherapy Induction Followed by Surgical Resection in Patients with Advanced Thymic Epithelial Tumors: A Retrospective Study.

BACKGROUND: This study aimed to evaluate the prognosis of concurrent chemo-radiotherapy (CCRT) versus sequential chemo-radiotherapy (SCRT) induction followed by surgical resection in patients with advanced thymic epithelial tumors (TETs). METHODS: This retrospective study included patients with advanced TETs who underwent CCRT or SCRT induction followed by surgical resection at the Second General Hospital of Guangdong Province between January 2008 and December 2019. The primary outcomes were induction response rate and surgical complete resection rate. The secondary outcomes were surgery combined resection, post-induction T staging, postoperative TNM staging, postoperative pathological tumor regression grade, progression-free survival (PFS) and overall survival (OS), and adverse events (AEs). RESULTS: A total of 31 patients were included, 15 of whom received CCRT and the other 16 SCRT. The induction response rates were 80.0 and 62.5%, respectively, the post-induction step-down rates were 46.7 and 31.3%, respectively, and the post-induction R0 resection rates were 80.0 and 68.8%, respectively, without significant differences between CCRT and SCRT groups (all P > 0.05). The 5-year OS rate was 64.2 and 51.6%, respectively, and PFS was 42.3 and 21.4%, respectively, without significant differences between CCRT and SCRT groups (both P > 0.05). AEs in the hematologic system were significantly higher with CCRT compared with SCRT (P = 0.009). CONCLUSIONS: Patients with advanced TETs might have a good prognosis with both CCRT and SCRT induction therapy, while SCRT induction may result in a lower probability of AEs in the hematologic system.

Chest wall reconstruction with digitally designed materials for straight back syndrome with tracheal stenosis: a case report.

Severe symptoms of straight back syndrome (SBS) occur through compression of the mediastinal structures. The treatment is to relieve compression, but surgical relief has not been reported. A 29-year-old woman was admitted to hospital because of dyspnea for 2 years. Physical examination showed the physiological curvature of the spine had disappeared and imaging examination confirmed that the spine was straight, the distance between the spine and the anterior chest wall was shortened, and the lower part of the trachea was obviously compressed with a severe stenosis. The chest wall was simulated by 3D technology, and a model was obtained by 3D printing. The surgical resection was simulated on the model, and the required replacement material was digitally designed and processed. The upper half of the sternum, the first and second costal cartilages, and the thymus were excised. After the chest wall defect was repaired with the digital material, the ascending aorta was suspended on the reconstruction to relieve the tracheal compression. The operation was completed in 135 min without any complications. All symptoms disappeared after operation. Postoperative imaging examination showed complete resolution of the tracheal stenosis. The patient was discharged 10 days after operation. Surgical reconstruction of the anterior chest wall is a good method for treating tracheal stenosis in SBS, and digitally produced material is ideal for the reconstruction.