Radiation dose for thymic tumours

Thymomas and thymic carcinomas are rare epithelial cell tumours arising from the thymus. Definitive surgical resection continues to be the primary approach for the management of thymomas and thymic carcinomas. However, complete resection is not always achievable due to the complexity of the mediastinal anatomy and in rare cases local recurrences may occur which are often incurable. Therefore, the use of Post-Operative Radiotherapy (PORT) may be considered with the intent of improving local control while being judicious of toxicity in the setting of prolonged clinical trajectories and proximity to critical structures. There continues to be a paucity of literature surrounding the use of PORT for thymomas and thymic carcinomas and the optimal dose has not yet been established. This review aims to summarize the current literature regarding radiotherapy indications and to explore issues surrounding radiotherapy dose-response-relationships for thymomas and thymic carcinoma. Long-term prospective studies using contemporary surgical and radiotherapy techniques are needed to further elucidate the optimal radiation approach in the management of thymic tumours.