Successful Concurrent Chemoradiotherapy with Cisplatin plus Vinorelbine for Locally Advanced Thymic Carcinoma
A previously healthy 53-year-old man was admitted to a local hospital because of an abnormality on chest radiography detected during health screening in October 2009. Chest computed tomography (CT) revealed an abnormal mass in the anterior and middle mediastinum (fig. ). 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed positive uptake in the mediastinal mass and right supraclavicular lymph node (fig. ). The patient suddenly developed hoarseness, and left recurrent nerve paralysis was detected. He was referred to our hospital for further examination. Physical examination and laboratory studies revealed no specific findings. Endobronchial ultrasound-guided transbronchial needle aspiration was performed for the mediastinal mass. The histological findings revealed undifferentiated type of carcinoma and the tumor cells were positive for CD 5. These findings were consistent with thymic carcinoma. Brain magnetic resonance imaging (MRI) revealed no brain metastasis. According to the classification of Masaoka et al. [], the patient had advanced disease with supraclavicular lymph node metastasis (IVb).\nConcurrent chemoradiotherapy was selected as treatment. The chemotherapy regimen consisted of cisplatin (80 mg/m2, day 1) and vinorelbine (25 mg/m2, days 1 and 8) every 4 weeks and concurrent thoracic radiation therapy (2 Gy × 30 fractions, total 60 Gy). Partial response was achieved when 4 cycles of chemotherapy had been completed (fig. ). He has remained well for approximately 4 years without any evidence of relapse.