title: Chemotherapy with gemcitabine plus cisplatin in patients with advanced thymic squamous cell carcinoma: Evaluation of efficacy and toxicity.
abstract: BACKGROUND
  Squamous cell carcinoma of the thymus is a rare thymic epithelial neoplasm that tends to widely metastasize at initial presentation. Because of its rarity, the optimal chemotherapeutic regimen remains uncertain. A gemcitabine and cisplatin regimen has shown promising efficacy in the treatment of other squamous cell carcinomas. We assessed the efficacy and toxicity of this regimen in patients with advanced thymic squamous cell carcinoma.
  
  
  METHODS
  Between January 2003 and December 2012, 13 patients with untreated or unresectable recurrent thymic squamous cell carcinomas, who were treated with gemcitabine and cisplatin, were retrospectively analyzed. The endpoints in this study were clinical response rate, disease control rate, progression-free survival, and overall survival. Significant hematological and non-hematological toxicities were also assessed.
  
  
  RESULTS
  Three patients were in Masaoka stage IVa and 10 were in stage IVb. The median number of treatment cycles for the present chemotherapy regimen was four. The clinical response and disease control rates were 61.5% and 92.3%, respectively. The median progression-free and median overall survival rates were 14.5 months (95% confidence interval, 9.2-19.8 months) and 50.7 months (95% confidence interval, 24.9-76.5 months), respectively. Grade 3/4 hematological toxicities were observed in seven (53.8%) patients, and non-hematological toxicities were mild.
  
  
  CONCLUSIONS
  This retrospective analysis demonstrated that gemcitabine plus cisplatin was active against advanced thymic squamous cell carcinoma with manageable toxicity. Gemcitabine may be a novel and alternative agent for advanced thymic squamous cell carcinoma.
authors.affiliation: Department of Medical Oncology Cancer Institute/Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Medical Oncology Cancer Institute/Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China.
authors.forename: Jun-Ling
authors.initials: JL
authors.lastname: Li
authors.affiliation: Department of Pathology Cancer Institute/Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Medical Oncology Cancer Institute/Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
keywords: Cisplatin; gemcitabine; squamous cell carcinoma; thymic carcinoma