Advanced Thymoma Successfully Treated with Cisplatin, Doxorubicin, and Methylprednisolone Therapy as Induction Chemotherapy: Two Surgical Cases and a Review of the Literature

Abstract

INTRODUCTION: Multimodal treatment is required for advanced thymic epithelial tumors. However, to date, no pharmacotherapy has been established. Herein, we present 2 cases in which preoperative cisplatin, doxorubicin, and methylprednisolone (CAMP) therapies were effective.

CASE PRESENTATION: Case 1: A woman in her 70s was diagnosed with clinical stage IVA thymoma with intrathoracic dissemination. The patient received 2 cycles of induction therapy with CAMP, resulting in a partial response. Robot-assisted thoracoscopic resection of a mediastinal tumor and pleural lesions was successfully performed. Pathology revealed a type B2 thymoma (ypT1aN0M1a, stage IVA). Case 2: A woman in her 70s was diagnosed with clinical stage IIIA thymoma invading the upper lobe of the left lung. Two cycles of CAMP therapy resulted in sufficient tumor shrinkage to allow resection of only the upper division of the left lung along with resection of the thymoma, thereby avoiding lobectomy. Pathology confirmed type B2 thymoma (ypT3N0M0, stage IIIA), and adjuvant radiotherapy was administered postoperatively.

CONCLUSIONS: CAMP therapy was effective as induction chemotherapy in 2 cases of advanced thymoma, allowing for less invasive surgical approaches. Following this regimen, minimally invasive surgery was performed in one case, and the extent of pulmonary resection was reduced in the other. Therefore, this regimen may offer functional preservation and serve as a useful option for multimodal treatment.