The result of Radiotherapy in Mailgnant Thymona

1979년부터 1987년까지 서울대학교병원 치료방사선과에서 흉선암으로 근치목적의 방사선치료를 받은 21명을 대상으로 조사하였다. 전체환자의 3년 생존율은 80.5%, 3년 무병생존율은 78.6%였다. 근무력증을 동반한 환자는 43.5%였고 치료후 40%(4/10)에서 증상의 호전을 보였다. 증상의 유무에 따른 3년 생존율을 비교하여 보면 각각 90%, 78.8%였으며 근무력증이 예후에 나쁜 영향을 주는 인자가 아님을 알 수 있었다. 방사선치료후 환전관해율 및 부분관해율은 (33% vs 56%) 89%였고 이에 따른 3년 생존율은 각각 88.9%, 81.7%로 통계학적으로 유의한 차이는 보이지 않았다. 수술정도에 따른 치료실패율을 비교하여 보면 절제가 가능한 환자에서는 치료실패가 없었으나, 절제가 불가능하였던 환자 15명중 4명에서 국소실패, 1명이 골전이 소견을 보였다. 국소치료실패가 대부분으로 원격전이율은 낮은 양상을 보였다.

Twenty one patients of malignant thymoma treated with curative aim at the department of Therapeutic Radiotherapy of Seoul National University Hospital from 1979 to 1987 were analysed retrospectively. The 3 year overall and relapse free survival rate was 80.5% and 78.6%, respectively. Myasthenia gravis (MG) was seen in 43.5% at presentation and disappeard in 40% (4/10) after radiotherapy with or without operation. The 3 year cumulative survival rate with and without MG was 90% and 78.8%, respectively. We could consider that MG was no longer adverse prognostic factor. The complete response rate after partial resection was 100% (3/3), and that after biopsy was 20% (3/15). The overall local control rate including complete and partial response rate (33% vs 56%) was 89% and the 3 year actuarial survival rate by the response rate 88.9% and 81.7%, respectively. there was no statistically significant survival difference between two groups. The crude rate of relapse at 3 years was 23.8% (5/21), and 80% (4/5) were locoregional failures. All failures were observed in biopsy only group, while no failure was observed in resected group. The major pattern of the treatment failure was the locoregional failure and the distant metastases was rarely observed.