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Purpose <p>We aimed to evaluate current practices among radiation oncologists in Turkey in the treatment of thymoma patients, including preferred staging systems, indications for adjuvant radiotherapy (RT), and RT dose schemes.</p> Materials and methods <p>We distributed a 19-item online questionnaire to 120 radiation oncologists affiliated with the TROD Thoracic Oncology Working Group. The survey covered demographics, clinical workflow, treatment indications, staging system preferences, guideline utilization, and RT dose regimens.</p> Results <p>Fifty-three physicians participated. Most had ≥ 10&#xa0;years of experience (85%) and academic titles (60%). A thoracic oncology tumor board was operated in 60.4% of centers. The Masaoka staging system was preferred by 66%, while TNM was used by 28.3%. In stage II thymoma patients with R0 resection, 67.9% recommended adjuvant RT regardless of histological subtype if there was capsular proximity. In stage IIA, the indication for RT was especially frequent for B2–B3 histology (45.3%), and similarly in stage IIB (43.4%). For locally advanced but potentially resectable cases, 43.4% favored induction chemotherapy followed by surgery, and 28.3% performed postoperative RT. In potentially unresectable disease, neoadjuvant chemoradiotherapy (47.2%) and definitive chemoradiotherapy (35.8%) were common. Postoperative RT doses varied: R0 resections most often received 45–50 Gy (85%), rising to 50–54 Gy (79.2%) if capsular proximity was present. R1 resections more often received 50–54 Gy (41.5%) or 54–60 Gy (39.6%). R2 disease was usually treated with higher doses (54–70 Gy, most frequently 66–70 Gy at 37.7%). After induction chemotherapy, neoadjuvant RT most commonly used 45–50 Gy (67.9%), while definitive RT typically used 60–66 Gy (43.4%) or 66–70 Gy (39.6%).</p> Conclusions <p>Multidisciplinary management aligned with international guidelines is common in thymoma treatment in Turkey. Capsular proximity and histological subtype are key determinants for adjuvant RT decisions. Postoperative RT doses were escalated according to residual tumor burden and resection status. In locally advanced or unresectable cases, neoadjuvant strategies are widely adopted.</p>

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Patterns of care in the use of radiotherapy for thymoma: a TROD thoracic oncology working group survey (TROD 08-013)

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Nuri Kaydıhan,
  • Esra Kaytan Sağlam,
  • Fazilet Öner Dinçbaş

摘要

Purpose

We aimed to evaluate current practices among radiation oncologists in Turkey in the treatment of thymoma patients, including preferred staging systems, indications for adjuvant radiotherapy (RT), and RT dose schemes.

Materials and methods

We distributed a 19-item online questionnaire to 120 radiation oncologists affiliated with the TROD Thoracic Oncology Working Group. The survey covered demographics, clinical workflow, treatment indications, staging system preferences, guideline utilization, and RT dose regimens.

Results

Fifty-three physicians participated. Most had ≥ 10 years of experience (85%) and academic titles (60%). A thoracic oncology tumor board was operated in 60.4% of centers. The Masaoka staging system was preferred by 66%, while TNM was used by 28.3%. In stage II thymoma patients with R0 resection, 67.9% recommended adjuvant RT regardless of histological subtype if there was capsular proximity. In stage IIA, the indication for RT was especially frequent for B2–B3 histology (45.3%), and similarly in stage IIB (43.4%). For locally advanced but potentially resectable cases, 43.4% favored induction chemotherapy followed by surgery, and 28.3% performed postoperative RT. In potentially unresectable disease, neoadjuvant chemoradiotherapy (47.2%) and definitive chemoradiotherapy (35.8%) were common. Postoperative RT doses varied: R0 resections most often received 45–50 Gy (85%), rising to 50–54 Gy (79.2%) if capsular proximity was present. R1 resections more often received 50–54 Gy (41.5%) or 54–60 Gy (39.6%). R2 disease was usually treated with higher doses (54–70 Gy, most frequently 66–70 Gy at 37.7%). After induction chemotherapy, neoadjuvant RT most commonly used 45–50 Gy (67.9%), while definitive RT typically used 60–66 Gy (43.4%) or 66–70 Gy (39.6%).

Conclusions

Multidisciplinary management aligned with international guidelines is common in thymoma treatment in Turkey. Capsular proximity and histological subtype are key determinants for adjuvant RT decisions. Postoperative RT doses were escalated according to residual tumor burden and resection status. In locally advanced or unresectable cases, neoadjuvant strategies are widely adopted.