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Updated: Jul 7, 2026
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Pretargeted Radioimmunotherapy Based on the Inverse Electron Demand Diels-Alder Reaction
Published on: January 29, 2019
Pathologic radioresponse of preoperatively irradiated invasive thymomas
Takuya Onuki1, Shigemi Ishikawa, Tatsuo Yamamoto
1Department of Chest Surgery and Radiation Oncology, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Summary
Preoperative radiotherapy (RT) effectively reduced stage III thymoma size, particularly in WHO B1 and B2 subtypes. While RT showed macroscopic and histopathologic benefits, its overall impact on survival requires further investigation.
Area of Science:
- Oncology
- Thoracic Surgery
- Radiation Oncology
Background:
- Preoperative radiotherapy (RT) is used for Masaoka stage III thymomas to improve surgical outcomes.
- Tumor response to RT varies, suggesting histology influences radiosensitivity.
- Hypothesis: Thymoma radiosensitivity depends on pretreatment histology.
Purpose of the Study:
- To analyze the efficacy of preoperative RT in stage III thymomas.
- To evaluate the impact of RT on tumor volume, histopathology, resectability, and survival.
- To determine if WHO histologic subtypes correlate with RT response.
Main Methods:
- Retrospective analysis of 21 stage III thymomas treated with preoperative RT, surgery, and postoperative RT (1982-2004).
- Assessment of tumor reduction ratios, WHO histologic changes, and resection completeness.
- Evaluation of long-term survival and disease control rates.
Main Results:
- 16 tumors (76.2%) showed size reduction after preoperative RT (mean 30.8%).
- WHO B1 and B2 thymomas exhibited significantly higher reduction ratios than B3.
- Histopathologically, B1 and B2 showed lymphocyte and/or epithelial cell reduction, unlike B3.
- Complete resection was 90.5%; 10-year overall and disease-free survival were 77.6% and 83.6%, respectively, irrespective of WHO subtype.
Conclusions:
- Preoperative RT at modest doses is macroscopically and histopathologically effective, especially in WHO B1 and B2 thymomas compared to B3.
- The therapeutic benefit of the combined modality (preoperative RT, surgery, postoperative RT) for stage III thymomas warrants thorough definition.
