title: Treatment of invasive thymoma with single-agent ifosfamide.
abstract: OBJECTIVE
  To evaluate single-agent ifosfamide in the treatment of invasive thymoma.
  
  
  METHODS
  Fifteen patients (eight male and seven female) with histologically confirmed invasive thymoma were treated. The median age was 48 years (range, 23 to 76 years). Four patients had stage III disease, seven patients had stage IVa disease, and four patients had stage IVb disease. The most common histologic type was lymphoepithelial. Seven patients had received prior treatment, including one patient who received chemotherapy. Ifosfamide 1.5 g/m(2) was given on days 1 to 5, with mesna as a uroprotector.
  
  
  RESULTS
  Thirteen patients were assessable for response. Five complete responses (38.5%; 95% confidence interval [CI], 17.7% to 64.5%) and one partial response (7.7%; 95% CI, 1.4% to 33.3%) were seen. The median duration of complete response was 66+ months (range, 25 to 87 months), and the estimated survival rate 5 years after ifosfamide treatment was 57% (SE, 32% to 79%). The most frequent toxicities were nausea, vomiting, and leucopenia, but these were well tolerated.
  
  
  CONCLUSIONS
  Single-agent ifosfamide possesses significant activity against invasive thymoma and is comparable to currently used combination regimens. The inclusion of ifosfamide in combination therapy, particularly in place of cyclophosphamide in regimens such as cisplatin, doxorubicin, and cyclophosphamide, needs to be evaluated.
authors.affiliation: Departments of Oncology and Surgery, Guy's Hospital, and the Brook Hospital, London.
authors.forename: M S
authors.initials: MS
authors.lastname: Highley
authors.forename: C R
authors.initials: CR
authors.lastname: Underhill
authors.forename: F X
authors.initials: FX
authors.lastname: Parnis
authors.forename: C
authors.initials: C
authors.lastname: Karapetis
authors.forename: E
authors.initials: E
authors.lastname: Rankin
authors.forename: J
authors.initials: J
authors.lastname: Dussek
authors.forename: B
authors.initials: B
authors.lastname: Bryant
authors.forename: C
authors.initials: C
authors.lastname: Rowland
authors.forename: N
authors.initials: N
authors.lastname: Hodson
authors.forename: J
authors.initials: J
authors.lastname: Hughes
authors.forename: P G
authors.initials: PG
authors.lastname: Harper
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015996:Survival Rate; D013945:Thymoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D013953:Thymus Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology
chemical_list: D018906:Antineoplastic Agents, Alkylating; D007069:Ifosfamide