Weekly chemotherapy with cisplatin, vincristine, doxorubicin, and etoposide is an effective treatment for advanced thymic carcinoma.
BACKGROUND
Thymic carcinoma is a rare neoplasm that often disseminates or metastasizes. The role of chemotherapy in treating this malignancy is unclear. The purpose of the current study was to determine the efficacy and tolerability of a weekly chemotherapy regimen consisting of cisplatin, vincristine, doxorubicin, and etoposide (CODE) for the treatment of advanced thymic carcinoma.


METHODS
The authors retrospectively reviewed 18 patients with thymic carcinoma who were treated between 1996 and 2002. Twelve of these patients had unresectable advanced diseases and received weekly chemotherapy according to the CODE regimen. The CODE regimen consisted of cisplatin (25 mg/m(2), intravenously [i.v.]; weekly administration), vincristine (1 mg/m(2), i.v.; administered during Weeks 1, 2, 4, 6, and 8), doxorubicin (40 mg/m(2), i.v.; administered during Weeks 1, 3, 5, 7, and 9), and etoposide (80 mg/m(2), i.v.; administered for 3 days during Weeks 1, 3, 5, 7, and 9).


RESULTS
The responses of all 12 patients to the CODE regimen were assessed. A partial response was achieved in 5 patients, and the overall response rate was 42%. Only one patient experienced disease progression. The median progression-free survival period was 5.6 months (range, 2-39 months). The overall survival period ranged from 6 to 79 months, with a median survival period of 46 months. Based on the Kaplan-Meier method, the estimated 1-year and 2-year survival rates were 80% and 58%, respectively. The most common side effects were hematologic toxicities, and only mild nonhematologic toxicities were experienced.


CONCLUSIONS
Weekly chemotherapy treatments according to the CODE regimen were effective and tolerated by patients with advanced thymic carcinoma.
Yoh
Kiyotaka
K
Division of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. kyoh@east.ncc.go.jp
Goto
Koichi
K
Ishii
Gen-ichiro
G
Niho
Seiji
S
Ohmatsu
Hironobu
H
Kubota
Kaoru
K
Kakinuma
Ryutaro
R
Nagai
Kanji
K
Suga
Moritaka
M
Nishiwaki
Yutaka
Y
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013953:Thymus Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D002945:Cisplatin