Nothing triggers my imposter syndrome more than planning post-operative radiotherapy for thymoma! As mentioned in a previous post, it really is an art – and like all art, it’s subjective.
However, two key papers help reassure me. The work of Florit Marcuse highlights the importance of collaborative working, while Andreas Rimner‘s research shows that in experienced hands, post-operative radiotherapy for thymoma does a good job! In-field recurrences are rare (as I see in my own practice).
When it comes to rare cancers like thymoma, selecting a radiation oncologist who treats patients with this condition regularly is essential. Repetition builds pattern recognition, making something rare routine.
Marcuse F et al. Radiotherapy and Oncology. 2021;165:8-13
Rimner A et al. Journal of Thoracic Oncology. 2014;9(3):403-9
I gave a talk at MSKCC recently about a part of my job that I consider to be as much an art as it is a science – post-operative radiotherapy for thymoma.
As our radiotherapy delivery gets more precise, the accuracy of the target becomes even more important. This ‘art’ comes from the expertise of the oncologist, thorough communication with the thoracic surgeon, and excellence in histopathology. MDT working at its best!
Thymomas are a rare cancer, but tend to occur in a younger age group, so the risks of secondary malignancy or radiation-associated heart disease need to be considered. My personal opinion is that proton beam therapy needs to be considered for every patient receiving adjuvant radiotherapy for thymoma.
Thanks to ITMIG for always championing the cause of this underrepresented patient group.