[The clinical outcomes of thymectomy combined with radiotherapy or cyclophosphamide treatment for myasthenia gravis patients with thymoma].
OBJECTIVE
To evaluate the therapeutic effects of thymectomy in myasthenia gravis (MG) patients with thymoma.


METHODS
A total of 178 MG patients with thymectomy between July 2008 and December 2010 were included. All the subjects were received either cyclophosphamide alone or in combination with radiotherapeutic treatment after surgery. The MG absolute and relative clinical scores were used to assess the effectiveness of long-term treatments. Clinical evaluations were conducted before, and at 1 , 6, 12 and 24 months after operation. A comparative analysis on the inter-relationships among MG clinical presentation, WHO histology and Masaoka stage was also conducted.


RESULTS
(1) Of the 178 thymoma-patients, 103 were male and 75 were female, with a mean age of (43.7 +/- 12.5)-years old. One hundred and twelve cases were taken cyclophosphamide, and 58 cases with invasive thymoma (stages II , III and IV or WHO type B3 ) were taken cyclophosphamide in combination with radiotherapy. Five patients refused cyclophosphamide or radiotherapy and 3 did not finish treatment. (2) The muscular strength improved obviously in 32.8% (58/177) of the patients after 1 month after thymectomy, and 59.8% (101/169), 69.7% (115/165) and 81.5% (132/162) after 6 months, 1 year and 2 years, respectively with MG score for disease severity decreased significantly with time. (3) No significant differences of the improvement rates were observed in patients within different WHO histology category. However, the rates were much higher in patients with Masaoka stage I (91.4%) and stage I (89.8%) than those in patients with stage III (45.5%) and IV (28.6%) (all P < 0.001) .


CONCLUSIONS
The remission rate of MG patients with thymomas increase after thymectomy plus cyclophosphamide or in combination with radiotherapy and reached 81.5% after 2 years. The remission rate is associated with Masaoka stage, but not with WHO histology.
Yuping
Y
Chen
Juan
J
Zhang
Wei
W
Wang
Zhongkui
Z
Wang
Yunke
Y
Dou
Dongning
D
Wei
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D013934:Thymectomy; D013945:Thymoma / Q000473:pathology / Q000628:therapy*; D013953:Thymus Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
D003520:Cyclophosphamide