【摘要】 目的胸腺癌是一种罕见的纵隔恶性肿瘤,其生物学行为完全有别于胸腺瘤,回顾性分析30年来治疗的51例胸腺癌治疗结果,旨在提高对该病诊断和治疗上的认识。方法51例患者中男36例,女15例,中位年龄49岁。Masaoka分期Ⅱ期5例,Ⅲ期34例,ⅣA期5例,ⅣB期7例。46例接受外科治疗,其中完全切除19例,不完全切除23例,仅做活检4例。51例不同时期常规放疗的中位剂量5586 cGy(2250~7000 cGy),其中单纯放疗1例,术后复发放疗4例。27例在不同时期接受了环磷酰胺、阿霉素、顺铂,氟尿嘧啶、长春新碱等的化疗。用Kaplan-Meier法计算总生存率、局部控制率。Cox回归比例风险模型分析影响生存的预后因素。结果5年总生存率为55%。5年局部控制率为71%。单因素分析表明Masaoka分期是影响胸腺癌预后的因素,但多因素分析无任何因素为胸腺癌的独立预后因子。结论5年总生存率较高,体现了手术为主辅以术后放疗是胸腺癌较理想的治疗模式。更多还原

【Abstract】 Objective As thymic carcinoma is a rare neoplasm,imformation regarding its result of treatment and possible prognostic factors are limited.We retrospectively analyzed 51 patients with pathologically confirmed thymic carcinoma treated at the Cancer Hospital,Fudan University.Methods Fifty-one patients with pathologically confirmed thymic carcinoma were classified according to the Masaoka satging criteria: stage Ⅱ 5 patients,stage Ⅲ 34,stage ⅣA 5,and stage ⅣB 7.Nineteen patients underwent gross total resection,23 had subtotal resection,and 4 had biopsy alone.Irradiation dose ranged from 2250?cGy to 7000?cGy,with a median of 5586?cGy.Twenty-seven patients also received chemotherapy,including endoxan,adriamycin,cisplatin,5-Fu or vincristine.The data of clinical and follow-up were analysed.The overall survival,and local control rate were calculated by Kaplan-Meier method.Prognosis factors were analyzed by Cox regression model.Results The overall 5-year survival rate was 55%.The 5-year local control rate was 71%.Univariate statistical analysis showed the Masaoka stage showed significance prognostic factors.Conclusions With an overall 5-year survival rate of 55%,this result shows that surgery plus postoperative radiotherapy is a model and reasonable treatment for thymic carcinoma.更多还原