A pilot study of cisplatin and etoposide with and without radiotherapy for advanced malignant thymoma

Thymoma is a rare neoplasm of the mediastinum, for which very few data on the efficacy and safety of chemotherapy and chemoradiotherapy are available. The objective of this pilot study was to assess the safety and efficacy of cisplatin, etoposide, and radiotherapy for thymoma. Patients with advanced, previously-untreated thymoma (Masaoka classification), measurable disease, and a performance status of 0-2 were eligible, and were treated with cisplatin-plus-etoposide, together with radiotherapy when possible. One patient achieved complete response, and seven achieved partial responses. Progression-free survival was 37.7 months (95% confidence interval = 18.6-56.8 months). Ten patients had grade 4 neutropenia, and five patients had grade 3 febrile neutropenia. However, other toxicities were relatively mild. To date, only five patients (45.5%) have died, and the median survival time is 128.1 months (95% confidence interval = 51.6-204.6 months). Patients treated with chemoradiotherapy had a good response and long progression-free survival. The combination of cisplatin and etoposide with or without radiotherapy is effective for advanced thymoma, and has an acceptable toxicity.