The management of thymoma: a systematic review and practice guideline.
J Thorac Oncol
; 4(7): 911-9, 2009 Jul.
Article
em En
| MEDLINE
| ID: mdl-19557895
ABSTRACT
INTRODUCTION:
Thymoma is a rare tumor for which there is little randomized evidence to guide treatment. Because of the lack of high-quality evidence, a formal consensus-based approach was used to develop recommendations on treatment.METHODS:
A systematic refview of the literature was performed. Recommendations were formed from available evidence and developed through a two-round modified Delphi consensus approach.RESULTS:
The treatment recommendations are summarized as follows Stage I--complete resection of the entire thymus without neoadjuvant or adjuvant therapy. Stage II--complete resection of the entire thymus with consideration of adjuvant radiation for high-risk tumors. Stage IIIA--surgery either initially or after neoadjuvant therapy, or surgery followed by adjuvant therapy. Stage IIIB--treatment may include a combination of chemotherapy, radiation, and/or surgery, or if technically possible, surgery in combination with chemoradiotherapy (concurrent cisplatin based). For bulky tumors, consideration should be given to sequential chemotherapy followed by radiation. Stage IVA--as per stage III, with surgery only if metastases can be resected. Stage IVB--treatment on an individual case basis (no generic recommendations). Recurrent disease--consider surgery, radiation, and/or chemoradiation. Chemoradiation should be considered in all medically inoperable and technically inoperable patients.CONCLUSION:
Consensus was achieved on these recommendations, which serve to provide practical guidance to the physician treating this rare disease.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Timoma
/
Neoplasias do Timo
Tipo de estudo:
Clinical_trials
/
Guideline
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article