{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T16:17:57Z","timestamp":1761581877430,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Basic Research Program of China","doi-asserted-by":"publisher","award":["2016YFC0904900"],"award-info":[{"award-number":["2016YFC0904900"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Thymic carcinomas (TCs) are rare aggressive tumors with no standard first\u2010line treatment. This study was conducted to determine the optimal chemotherapy regimen for advanced TC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 67 patients treated for stage IV TC in 2006\u20132015. The primary endpoints were the objective response rate (ORR) and progression\u2010free survival (PFS) with different chemotherapy regimens. Multivariate Cox regression analysis was used to identify factors associated with PFS, including metastatic status, radiotherapy post\u2010chemotherapy, primary lesion resection before chemotherapy, and chemotherapy regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 36 patients received a paclitaxel\u2010platinum regimen, 31 received a gemcitabine\u2010platinum regimen, 14 underwent primary lesion resection, and 33 underwent radiotherapy. ORR was 31% (11\/36) and 29% (9\/31) in the paclitaxel\u2010platinum and gemcitabine\u2010platinum groups, respectively (<jats:italic>P<\/jats:italic> =\u20090.890). Median PFS, one\u2010year PFS rate, and two\u2010year PFS rate were 7.0 months, 26%, and 6% with paclitaxel\u2010platinum treatment and 12\u2009months, 48%, and 24% with gemcitabine\u2010platinum treatment (log\u2010rank <jats:italic>P<\/jats:italic> =\u20090.030). Median PFS, one\u2010year PFS rate, and two\u2010year PFS rate were 18.0 months, 57%, and 33% with surgical resection and 7.3 months, 31%, and 7% without resection (log\u2010rank <jats:italic>P<\/jats:italic> =\u20090.030). Median PFS, one\u2010year PFS rate, and two\u2010year PFS rate were 13.0 months, 52%, and 20% with radiotherapy and 4.3 months, 22%, and 7% without radiotherapy (log\u2010rank <jats:italic>P<\/jats:italic> =\u20090.001). In multivariate analysis, metastatic status (hazard ratio [HR], 0.33, <jats:italic>P<\/jats:italic> =\u20090.004), surgical resection (HR, 0.32; <jats:italic>P<\/jats:italic> =\u20090.004), and radiotherapy (HR, 0.32; <jats:italic>P<\/jats:italic> &lt;\u20090.001) were associated with superior PFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both gemcitabine\u2010platinum and paclitaxel\u2010platinum regimens were efficacious for advanced TC. Primary lesion resection and radiotherapy may also benefit selected patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.13181","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T23:48:41Z","timestamp":1569973721000},"page":"2081-2087","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Optimal first\u2010line treatment for advanced thymic carcinoma"],"prefix":"10.1111","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2768-1865","authenticated-orcid":false,"given":"Xue","family":"Yang","sequence":"first","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology Peking University Cancer Hospital and Institute  Beijing 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7975-6393","authenticated-orcid":false,"given":"Ziping","family":"Wang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology Peking University Cancer Hospital and Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meina","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology Peking University Cancer Hospital and Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tongtong","family":"An","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology Peking 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Education), Department of Thoracic Medical Oncology Peking University Cancer Hospital and Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanxiao","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology Peking University Cancer Hospital and Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Jia","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology Peking University Cancer Hospital and Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Dong","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of 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