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Surgery with or without PORT (stage II)
Source: Thymoma and Thymic Carcinoma Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: October 25, 2024 · Captured 2026-09-09.
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Context: Treatment of Thymoma / Stage I and Stage II Thymoma / Treatment options for stages I and II thymoma
For patients with stage II thymomas with pathologically demonstrated capsular invasion, adjuvant radiation therapy after complete surgical excision has been considered a standard of care, despite the lack of prospective clinical trials.[12,13] Most studies use 40 Gy to 70 Gy with a standard fractionation scheme (1.8–2.0 Gy per fraction).
The role and risks of adjuvant radiation therapy for patients with completely resected stage II thymomas need further study. To avoid the potential morbidity and costs associated with thoracic radiation, PORT may be reserved for stage II patients when adjacent organs are within a few millimeters or involve the surgical margin (close or positive surgical margins), as determined by both pathological and intraoperative findings.
Evidence (surgery followed by PORT):
Data were obtained from a clinical study of 1,320 Japanese patients.[14] Patients with stage I thymoma were treated with surgery only, and patients with stage II thymoma underwent surgery and additional radiation therapy.
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Data were obtained from a clinical study of 1,320 Japanese patients.[14] Patients with stage I thymoma were treated with surgery only, and patients with stage II thymoma underwent surgery and additional radiation therapy.
Prophylactic mediastinal radiation therapy did not appear to prevent local recurrences effectively in patients with totally resected stage II thymoma.
Some, but not all, retrospective clinical studies show improved local control and survival with the addition of PORT.[2,14-17][Level of evidence C3]
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Preserved source evidence · Not medical advice