Hypofractionated Radiation Therapy Combined With Weekly Chemotherapy in Patients With Unresectable or Recurrent Thymic Epithelial Tumor: A Prospective, Single-Arm Phase 2 Study (GASTO-1042).
Chu. Chu C; Liang. Ying Y; Lin. Xiaosheng X; Liu. Yimei Y; Liu. Songran S; Guo. Jinyu J; Wang. Daquan D; Wang. Junye J; Liu. Hui H; Qiu. Bo B
Key Findings
- Overall response rate was 83.7% and 2‑year overall survival was 90% in this tough cancer group
- Only 2% of patients got severe (grade 3) lung inflammation, possibly lowered by thymosin‑alpha‑1
- Quality of life stayed stable for most patients during the first year after treatment
Practical Outcomes
- The results suggest thymosin‑alpha‑1 could be a supportive add‑on for radiation therapy to reduce lung side‑effects, but it’s only relevant for patients receiving that specific cancer protocol. The dose used was 1.6 mg weekly during radiation and for two months after. It isn’t a general anti‑aging or performance supplement for healthy people.
Summary
This study tested a cancer treatment that combined precise radiation, weekly chemo, and a small dose of the peptide thymosin‑alpha‑1 in patients with hard‑to‑treat thymus tumors. The regimen showed good tumor shrinkage and survival, with very low rates of serious lung inflammation, and the peptide might have helped protect the lungs and keep quality of life stable. However, the findings are specific to cancer patients and not directly useful for everyday health‑hacking or longevity goals.
Abstract
This prospective phase 2 study aimed to evaluate the efficacy and safety of hypofractionated radiation therapy (HRT) combined with concurrent weekly chemotherapy in patients with unresectable or recurrent thymic epithelial tumors (TETs). Patients with unresectable or recurrent intrathoracic TETs that could be encompassed within the radiation fields were enrolled. HRT using intensity modulated radiation therapy (IMRT) technique was administered with 3 different levels of radiation doses (51 Gy/17 fractions (fx), 48 Gy/12 fx, and 45 Gy/9 fx; biologically effective dose of 66.3-67.5Gy), combined with weekly docetaxel (25 mg/m<sup>2</sup>) and nedaplatin (25 mg/m<sup>2</sup>). Weekly thymosin α1 (1.6 mg) was administered from the start to 2 months after radiation therapy. The objective response rate (ORR), progression-free survival (PFS), overall survival (OS), health-related quality of life (QOL), and toxicity were recorded. Fifty eligible patients enrolled from August 1, 2018, to July 1, 2020, were analyzed. Most patients (82.0%) had stage IVB tumors. Patients had IMRT-HRT (36-51 Gy in 9-17 fx, median biologically effective dose of 67.2 Gy) and concurrent weekly docetaxel/nedaplatin (2-4 cycles). During a median follow-up of 25.0 months (14.0-40.0), the ORR was 83.7%, the 2-year PFS was 59.1%, and the 2-year OS was 90.0%. There was 1 (2.0%) in-field recurrence while 19 (38.0%) patients developed out-of-field recurrence. Grade 3 pneumonitis was observed in 1 patient (2.0%). The ORR, 2-year PFS, 2-year OS, and toxicity were similar among 3 dose levels. Fourteen (28.0%) patients had 2 to 4 courses of radiation therapy because of recurrent diseases. Only 1 suffered from grade 1 pulmonary fibrosis during follow-up. Most patients (88%) maintained a stable QOL within 1 year after radiation therapy. IMRT-HRT and concurrent weekly docetaxel/nedaplatin was effective and well tolerated in unresectable or recurrent TETs. Considering the common out-of-field recurrence, this combined regimen could be an option for repeated radiation therapy. Thymosin α1 might help lower the incidence of pneumonitis and maintain the QOL.
Study Information
pubmed
2022
2022-05-20T00:00:00.000Z
10.1016/j.ijrobp.2022.05.015
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