Treatment of thymoma

The treatment of thymoma includes surgical resection, radiotherapy and chemotherapy.

1, surgical treatment. Thymoma should be treated by surgery. At present, surgical resection is the first choice, especially extended thymectomy, which is also the key to comprehensive treatment of thymoma. Surgical indications:

(1) Thymoma with complete capsule.

(2) The tumor invaded the surrounding tissues (mediastinum, pleura and pericardium), but it could be completely removed.

(3) If the tumor invades part of pulmonary lobe, left innominate vein, part of aortic adventitia, part of the wall of superior vena cava and a phrenic nerve, it can be completely or partially removed.

(4) Patients with obvious tumor invasion and superior vena cava syndrome can be implanted with superior vena cava artificial blood vessels at the same time of tumor resection.

(5) Thymoma with myasthenia gravis.

2. Radiotherapy. Because thymoma cells are sensitive to radiation, radiotherapy plays a very important role in the treatment of thymoma. Indications of radiotherapy:

(1) For invasive thymoma, postoperative radiotherapy should be given regardless of whether the surgical resection is complete or not.

(2) Non-invasive thymoma requires close observation and follow-up without postoperative radiotherapy.

(3) Advanced thymoma includes intrathoracic metastasis, intrapericardial metastasis, pleural metastasis and pulmonary metastasis.

(4) Preoperative radiotherapy is feasible for patients with large tumor or superior vena cava obstruction.

3. chemotherapy. With the continuous development of chemotherapy based on cisplatin, many scholars reported cases of chemotherapy for thymoma in stage ⅲ and ⅳ, and achieved certain results. Chemotherapy indications:

Palliative resection (1) of stage Ⅱ b and Ⅲ malignant thymoma, and the residual tumor should be treated with systemic chemotherapy after local radiotherapy.

(2) Stage Ⅳ b malignant thymoma has extensive metastasis of pericardium and parietal pleura or distant organ metastasis, and the first choice of treatment can only be systemic chemotherapy plus radiotherapy for local tumor focus.

(3) Stage Ⅲ and Ⅳ A invasive thymomas were treated with systemic chemotherapy, followed by surgery and postoperative radiotherapy after partial remission.