{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T21:31:35Z","timestamp":1781213495003,"version":"3.54.1"},"reference-count":40,"publisher":"Sociedade Brasileira de Pneumologia e Tisiologia","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Bras Pneumol."],"abstract":"<jats:p>Objective: Thymic tumors are a rare group of anterior mediastinal tumors. Surgery is the primary treatment. Adjuvant treatment is used in select cases. The purpose of this study was to evaluate the outcomes of patients with thymic tumors, submitted or not to radiotherapy, and identify risk factors that could impact the outcomes to better support patient selection for RT. Methods: This is a single institution retrospective cohort study. Patients with histologically proven thymoma or thymic carcinoma treated from July of 2009 to November of 2020 were included. Analysis was based on the use of radiation therapy (RT). Overall survival and disease-free survival were assessed from the date of diagnosis. To minimize selection bias, propensity score matching (PSM) regression using Kernel matching was used, estimated on the population for average treatment effect. Results: Overall, 101 patients were analyzed, with mean age at diagnosis of 54.6 years (range 25-84 years). Unfavorable histology and more advanced stages predominated in the cohort. Nevertheless, most (69.3%) were treated with radical intent. RT was delivered in 52.9% of these patients. Five-year OS, local progression and distant progression free survivals were 81.0%, 95.0% and 88.1%, respectively for the radical intent cohort. PSM showed that RT reduced the chances of death by 6.3% (matched sample size was 60, p = 0.02). Conclusions: In this retrospective cohort, RT had a positive impact in OS after PSM analysis. Prospective data regarding the role of RT in this disease is needed to validate these findings.<\/jats:p>","DOI":"10.36416\/1806-3756\/e20240331","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T19:24:43Z","timestamp":1748978683000},"page":"e20240331","source":"Crossref","is-referenced-by-count":1,"title":["Results of radiotherapy for thymoma: retrospective cohort and propensity score matching analysis"],"prefix":"10.36416","author":[{"given":"Jordana","family":"de Paula Soares1,2","sequence":"first","affiliation":[{"name":"1. Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil. 2. Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo - ICESP - Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Faria Najas2","sequence":"additional","affiliation":[{"name":"2. Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo - ICESP - Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geovanne","family":"Pedro Mauro1","sequence":"additional","affiliation":[{"name":"1. Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennya","family":"Medeiros Lopes de Barros Lima1","sequence":"additional","affiliation":[{"name":"1. Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Cerchi Angotti Ramos2","sequence":"additional","affiliation":[{"name":"2. Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo - ICESP - Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Henrique Xavier Nabuco de Araujo2","sequence":"additional","affiliation":[{"name":"2. Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo - ICESP - Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heloisa","family":"de Andrade Carvalho1","sequence":"additional","affiliation":[{"name":"1. Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo (SP) Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22288","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1.           Venuta F, Anile M, Diso D, Vitolo D, Rendina EA, De Giacomo T, et al. (2010). 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The Impact of Postoperative Radiotherapy for Thymoma and Thymic Carcinoma. J Thorac Oncol. 2017;12(4):734-744. https:\/\/doi.org\/10.1016\/j.jtho.2017.01.002","DOI":"10.1016\/j.jtho.2017.01.002"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8.           Mou H, Kong Y, Wu Y, Wu Y, Yu L. Effect of Postoperative Radiotherapy in Thymoma Patients: A SEER-Based Study. Oncol Res Treat. 2021;44(1-2):28-35. https:\/\/doi.org\/10.1159\/000508311","DOI":"10.1159\/000508311"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9.           Muslim Z, Baig MZ, Weber JF, Detterbeck FC, Connery CP, Spera JA, et al. Invasive thymoma - Which patients benefit from post-operative radiotherapy?. Asian Cardiovasc Thorac Ann. 2021;29(9):935-942. https:\/\/doi.org\/10.1177\/02184923211017094","DOI":"10.1177\/02184923211017094"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10.        Mou H, Liao Q, Hou X, Chen T, Zhu Y. 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The Prognostic Value of Postoperative Radiotherapy for Thymoma and Thymic Carcinoma: A Propensity-Matched Study Based on SEER Database. Cancers (Basel). 2022;14(19):4938. https:\/\/doi.org\/10.3390\/cancers14194938","DOI":"10.3390\/cancers14194938"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"13.        Lim YJ, Kim HJ, Wu HG. Role of Postoperative Radiotherapy in Nonlocalized Thymoma: Propensity-Matched Analysis of Surveillance, Epidemiology, and End Results Database. J Thorac Oncol. 2015;10(9):1357-1363. https:\/\/doi.org\/10.1097\/JTO.0000000000000619","DOI":"10.1097\/jto.0000000000000619"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"14.        Detterbeck FC, Nicholson AG, Kondo K, Van Schil P, Moran C. The Masaoka-Koga stage classification for thymic malignancies: clarification and definition of terms. J Thorac Oncol. 2011;6(7 Suppl 3):S1710-S1716. https:\/\/doi.org\/10.1097\/JTO.0b013e31821e8cff","DOI":"10.1097\/jto.0b013e31821e8cff"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"15.        Detterbeck FC, Stratton K, Giroux D, Asamura H, Crowley J, Falkson C, et al. The IASLC\/ITMIG Thymic Epithelial Tumors Staging Project: proposal for an evidence-based stage classification system for the forthcoming (8th) edition of the TNM classification of malignant tumors. J Thorac Oncol. 2014;9(9 Suppl 2):S65-S72. https:\/\/doi.org\/10.1097\/JTO.0000000000000290","DOI":"10.1097\/jto.0000000000000290"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"16.        Kondo K, Yoshizawa K, Tsuyuguchi M, Kimura S, Sumitomo M, Morita J, et al. WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg. 2004;77(4):1183-1188. https:\/\/doi.org\/10.1016\/j.athoracsur.2003.07.042","DOI":"10.1016\/j.athoracsur.2003.07.042"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"17.        Mangi AA, Wright CD, Allan JS, Wain JC, Donahue DM, Grillo HC, et al. Adjuvant radiation therapy for stage II thymoma. Ann Thorac Surg. 2002;74(4):1033-1037. https:\/\/doi.org\/10.1016\/S0003-4975(02)03828-6","DOI":"10.1016\/s0003-4975(02)03828-6"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"18.        Chang JH, Kim HJ, Wu HG, Kim JH, Kim YT. Postoperative radiotherapy for completely resected stage II or III thymoma. J Thorac Oncol. 2011;6(7):1282-1286. https:\/\/doi.org\/10.1097\/JTO.0b013e31821f9662","DOI":"10.1097\/jto.0b013e31821f9662"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"19.        Mastromarino MG, Bacchin D, Aprile V, Ceccarelli I, Korasidis S, Lenzini A, et al. Unradical Surgery for Locally-Advanced Thymoma: Is it time to evolve Perspectives?. Lung Cancer. 2023;180:107214. https:\/\/doi.org\/10.1016\/j.lungcan.2023.107214","DOI":"10.1016\/j.lungcan.2023.107214"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"20.        Dumont J, Bou-Gharios J, Keller A, Chambrelant I, Pamart G, Mascaux C, et al. Impact of adjuvant radiotherapy and chemotherapy on thymoma. Cancer Radiother. 2024;28(2):174-181. https:\/\/doi.org\/10.1016\/j.canrad.2023.08.009","DOI":"10.1016\/j.canrad.2023.08.009"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"21.        Zhou D, Liu QX, Zheng H, Lu X, Dai JG. Postoperative radiotherapy for completely resected thymoma: Differing roles in masaoka stage II and stage III disease. Asian J Surg. 2022;45(12):2670-2675. https:\/\/doi.org\/10.1016\/j.asjsur.2022.01.128","DOI":"10.1016\/j.asjsur.2022.01.128"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"22.        Jackson MA, Ball DL. Post-operative radiotherapy in invasive thymoma. Radiother Oncol. 1991;21(2):77-82. https:\/\/doi.org\/10.1016\/0167-8140(91)90078-U","DOI":"10.1016\/0167-8140(91)90078-u"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"23.        Ogawa K, Toita T, Kakinohana Y, Kamata M, Koja K, Genga K. Postoperative radiation therapy for completely resected invasive thymoma: prognostic value of pleural invasion for intrathoracic control. Jpn J Clin Oncol. 1999;29(10):474-478. https:\/\/doi.org\/10.1093\/jjco\/29.10.474","DOI":"10.1093\/jjco\/29.10.474"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"24.        P\u00eago-Fernandes PM, Ebaid GX, Galizia MS, Marchiori P, Suso FV, Jatene FB. Thymoma: discussion about treatment and diagnosis [Article in Portuguese]. J Pneumol, 2001;27(6):289-294. https:\/\/doi.org\/10.1590\/S0102-35862001000600001","DOI":"10.1590\/s0102-35862001000600001"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"25.        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Rep Pract Oncol Radiother. 2023;28(4):454-462. https:\/\/doi.org\/10.5603\/RPOR.a2023.0050","DOI":"10.5603\/rpor.a2023.0050"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"31.        Basse C, Botticella A, Molina TJ, Falcoz PE, Oulkhouir Y, Kerjouan M, et al. RADIORYTHMIC: Phase III, Opened, Randomized Study of Postoperative Radiotherapy Versus Surveillance in Stage IIb\/III of Masaoka Koga Thymoma after Complete Surgical Resection. Clin Lung Cancer. 2021;22(5):469-472. https:\/\/doi.org\/10.1016\/j.cllc.2021.01.020","DOI":"10.1016\/j.cllc.2021.01.020"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"32.        Fan C, Ge H, Zhang S, Xing W, Ye K, Zheng Y, et al. Impact of Definitive Radiotherapy and Surgical Debulking on Treatment Outcome and Prognosis for Locally Advanced Masaoka-Koga stage III Thymoma. 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Neoadjuvant chemoradiotherapy for locally advanced thymic tumors: a phase II, multi-institutional clinical trial. J Thorac Cardiovasc Surg. 2014;147(1):36-46.e1. https:\/\/doi.org\/10.1016\/j.jtcvs.2013.08.061","DOI":"10.1016\/j.jtcvs.2013.08.061"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"36.        Kim ES, Putnam JB, Komaki R, Walsh GL, Ro JY, Shin HJ, et al. Phase II study of a multidisciplinary approach with induction chemotherapy, followed by surgical resection, radiation therapy, and consolidation chemotherapy for unresectable malignant thymomas: final report. Lung Cancer. 2004;44(3):369-379. https:\/\/doi.org\/10.1016\/j.lungcan.2003.12.010","DOI":"10.1016\/j.lungcan.2003.12.010"},{"key":"ref36","unstructured":"37.        Tamiya A, Matsumura A, Tsuji T, Morimoto M, Asami K, Okishio K, et al. A pilot study of cisplatin and etoposide with and without radiotherapy for advanced malignant thymoma. Anticancer Res. 2014;34(4):2023-2027."},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"38.        Kunitoh H, Tamura T, Shibata T, Takeda K, Katakami N, Nakagawa K, et al. A phase II trial of dose-dense chemotherapy, followed by surgical resection and\/or thoracic radiotherapy, in locally advanced thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9606). Br J Cancer. 2010;103(1):6-11. https:\/\/doi.org\/10.1038\/sj.bjc.6605731","DOI":"10.1038\/sj.bjc.6605731"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"39.        Fukuda M, Yamaguchi M, Yamazaki T, Funaki S, Mukae H, Fukuoka J, et al. Phase II study of S-1 plus cisplatin with concurrent radiotherapy for locally advanced thymic carcinoma: Results of the LOGIK1605\/JART-1501 study. Thorac Cancer. 2022;13(17):2499-2506. https:\/\/doi.org\/10.1111\/1759-7714.14586","DOI":"10.1111\/1759-7714.14586"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"40.        Loehrer PJ Sr, Kim K, Aisner SC, Livingston R, Einhorn LH, Johnson D, et al. Cisplatin plus doxorubicin plus cyclophosphamide in metastatic or recur-rent thymoma: final results of an intergroup trial. The Eastern Cooperative Oncology Group, Southwest Oncology Group, and Southeastern Cancer Study Group. 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