18例不可切除IV期胸腺鳞癌的临床特征及预后分析

Analysis of Clinical Characteristics and Prognosis of 18 Cases Unresectable Stage IV Thymic Squamous Cell Carcinoma

摘要: 目的：探讨不可切除IV期胸腺鳞癌的临床特征、治疗方式和预后。方法：收集2018年1月1日至2022年12月31日期间就诊于青岛大学附属医院的18例不可切除IV期胸腺鳞癌患者的临床资料和治疗资料，并随访至2024年2月29日。结果：18例患者中男性12例，女性6例，中位发病年龄60岁；TNM分期IVA期9例，IVB期9例；单纯化疗8例，单纯放疗1例，序贯放化疗4例，同步放化疗2例，化疗联合免疫疗法3例。18例患者总进展率66.7%，中位PFS 27 (19~36)个月。IVA期和IVB期进展率分别为33.3%和100.0% (p = 0.009)，中位PFS分别为50 (21~79)和21 (5~37)个月(p = 0.008)。单纯化疗，放化疗和化疗联合免疫疗法进展率分别为75.0%，66.7%，和33.3% (p = 0.793)，中位PFS分别为24 (16~32)，50 (27~73)，和10 (4~16)个月(p = 0.057)。结论：不可切除IV期胸腺鳞癌主要采用以化疗为主的综合治疗，总体预后差，IVA期较IVB期好，化疗联合放疗或免疫疗法较单纯化疗好，建议对非广泛转移阶段的患者行精准治疗。

Abstract: Objective: To investigate the clinicopathological characteristics, treatment, and prognosis of Thymic Squamous Cell Carcinoma (TSCC). Methods: We collected the data of 18 TSCC patients hospitalized in the Affiliated Hospital of Qingdao University from 1 January 2018 to 31 December2022 and followed them up until 29 February 2024. Results: Of the 18 cases, there were 12 males and 6 females. The median age was 60 years old. There were 10 cases with TNM stage IVA and 8 cases with stage IVB. 8 cases received chemotherapy alone, 1 case received radiotherapy alone, 4 cases received sequential chemoradiotherapy, 2 cases received concurrent chemoradiotherapy, and 3 cases received chemotherapy combined with immunotherapy. The progression rate of all cases was 66.7% and the median PFS was 27 (19~36) months. The progression rates of stage IVA and IVB were 33.3% and 100.0%, respectively (p = 0.009), and the median PFS was 50 (21~79) and 21 (5~37) months, respectively (p = 0.008). The progression rates of chemotherapy alone, chemoradiotherapy, and chemotherapy combined with immunotherapy were 75.0%, 66.7%, and 33.3%, respectively (p = 0.793), and the median PFS was 24 (16~32), 50 (27~73), and 10 (4~16) months, respectively (p = 0.057). Conclusions: Unresectable stage IV TSCC is mainly treated with chemotherapy as the main treatment. The prognosis is poor, with stage IVA better than stage IVB, and chemotherapy combined with radiotherapy or immunotherapy better than chemotherapy alone. Precision treatment is recommended for patients who haven’t experienced extensive metastasis.