Chemotherapy in the treatment of thymic tumors

Thymic tumors, including thymoma and thymic carcinoma, are mainly treated with surgical resection. The majority of patients with thymic tumors present with early stage and are cured with surgical excision with or without post-operative radiation. For the patients who present with unresectable stage III or IV disease, or for the patients who experience recurrence, chemotherapy can play a significant role in ensuring long-term survival and offering palliation. Thymic tumors are chemo-sensitive with optimal responses achieved with cisplatin-based combinations. A multimodality approach including chemotherapy and post-operative radiation can improve complete resection rates and longterm outcomes in locally advanced tumors. Patients with disseminated thymic tumors can have significant disease response and symptom palliation when treated with chemotherapy. Durable responses can be obtained both in metastatic and recurrent settings. Second-line treatments are available and novel therapies are currently being explored. This review provides an update of available evidence about the treatment of thymic tumors with chemotherapy. © Springer-Verlag 2008.