Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II study

Abstract Pleural spread or recurrence of thymic epithelial tumors (TETs) is a tricky puzzle in the clinic and there is currently no recognized effective treatment. This trial evaluated the safety and efficacy of cytoreductive surgery and hyperthermic intrathoracic chemotherapy (S-HITOC) for TETs wit...

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Main Authors: Shuai Wang, Xinyu Yang, Jiahao Jiang, Fei Liang, Yuansheng Zheng, Yongqiang Ao, Jian Gao, Hao Wang, Lijie Tan, Jianyong Ding
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-60386-0
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author Shuai Wang
Xinyu Yang
Jiahao Jiang
Fei Liang
Yuansheng Zheng
Yongqiang Ao
Jian Gao
Hao Wang
Lijie Tan
Jianyong Ding
author_facet Shuai Wang
Xinyu Yang
Jiahao Jiang
Fei Liang
Yuansheng Zheng
Yongqiang Ao
Jian Gao
Hao Wang
Lijie Tan
Jianyong Ding
author_sort Shuai Wang
collection DOAJ
description Abstract Pleural spread or recurrence of thymic epithelial tumors (TETs) is a tricky puzzle in the clinic and there is currently no recognized effective treatment. This trial evaluated the safety and efficacy of cytoreductive surgery and hyperthermic intrathoracic chemotherapy (S-HITOC) for TETs with pleural spread or recurrence. Here, we reported short-term outcomes of enrolled 45 patients receiving S-HITOC with 25 mg/m2 doxorubicin and 50 mg/m2 cisplatin. The pleural tumor index (PTI) has been proposed for evaluating pleural tumor burden. Treatment-related adverse events of grade ≥3 occurred in eight (17.8%) patients. The pain Visual analog scale (VAS) score was 5.4 ± 1.9 on the 1st day after treatment and was similar to that at baseline level on the 7th day after treatment (p = 0.218). There was no significant difference in the quality of life score (p = 0.676) between baseline and the 60th day after treatment. The estimated 2-year PFS and OS rates were 82.8% and 100.0%, respectively. Subgroup analyses revealed that patients with PTI scores >10 had worse PFS than those with PTI scores ≤10 (p < 0.001). S-HITOC had a manageable complication rate. Early clinical outcomes confirmed that S-HITOC offers encouraging oncological benefits for TETs and satisfactory control of myasthenia gravis. Trial number: NCT05446935.
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spelling doaj-art-6ddbc1970fa0406986d65f38eba54ff72025-08-20T03:26:47ZengNature PortfolioNature Communications2041-17232025-06-011611910.1038/s41467-025-60386-0Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II studyShuai Wang0Xinyu Yang1Jiahao Jiang2Fei Liang3Yuansheng Zheng4Yongqiang Ao5Jian Gao6Hao Wang7Lijie Tan8Jianyong Ding9Department of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Biostatistics, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityDepartment of Thoracic Surgery, Zhongshan Hospital, Fudan UniversityAbstract Pleural spread or recurrence of thymic epithelial tumors (TETs) is a tricky puzzle in the clinic and there is currently no recognized effective treatment. This trial evaluated the safety and efficacy of cytoreductive surgery and hyperthermic intrathoracic chemotherapy (S-HITOC) for TETs with pleural spread or recurrence. Here, we reported short-term outcomes of enrolled 45 patients receiving S-HITOC with 25 mg/m2 doxorubicin and 50 mg/m2 cisplatin. The pleural tumor index (PTI) has been proposed for evaluating pleural tumor burden. Treatment-related adverse events of grade ≥3 occurred in eight (17.8%) patients. The pain Visual analog scale (VAS) score was 5.4 ± 1.9 on the 1st day after treatment and was similar to that at baseline level on the 7th day after treatment (p = 0.218). There was no significant difference in the quality of life score (p = 0.676) between baseline and the 60th day after treatment. The estimated 2-year PFS and OS rates were 82.8% and 100.0%, respectively. Subgroup analyses revealed that patients with PTI scores >10 had worse PFS than those with PTI scores ≤10 (p < 0.001). S-HITOC had a manageable complication rate. Early clinical outcomes confirmed that S-HITOC offers encouraging oncological benefits for TETs and satisfactory control of myasthenia gravis. Trial number: NCT05446935.https://doi.org/10.1038/s41467-025-60386-0
spellingShingle Shuai Wang
Xinyu Yang
Jiahao Jiang
Fei Liang
Yuansheng Zheng
Yongqiang Ao
Jian Gao
Hao Wang
Lijie Tan
Jianyong Ding
Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II study
Nature Communications
title Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II study
title_full Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II study
title_fullStr Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II study
title_full_unstemmed Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II study
title_short Cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence: a prospective, single-arm, phase II study
title_sort cytoreductive surgery and hyperthermic intrathoracic chemotherapy in thymic epithelial tumors with pleural spread or recurrence a prospective single arm phase ii study
url https://doi.org/10.1038/s41467-025-60386-0
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