Guidelines
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 24, 2021; 12(4): 195-216
Published online Apr 24, 2021. doi: 10.5306/wjco.v12.i4.195
GOECP/SEOR radiotherapy guidelines for thymic epithelial tumours
Mikel Rico, Sonia Flamarique, Cristina Casares, Tamara García, Miriam López, Maribel Martínez, Javier Serrano, Manuel Blanco, Raúl Hernanz, Lourdes de Ingunza-Barón, Francisco José Marcos, Felipe Couñago
Mikel Rico, Maribel Martínez, Department of Radiation Oncology, Complejo Hospitalario de Navarra, Pamplona 31008, Navarra, Spain
Mikel Rico, Health Research Institute of Navarre (IdiSNA), Navarra Biomed, Pamplona 31008, Navarra, Spain
Sonia Flamarique, Department of Radiation Oncology, University Hospital Miguel Servet, Zaragoza 50009, Aragón, Spain
Cristina Casares, Francisco José Marcos, Department of Radiation Oncology, University Hospital of Caceres, Cáceres 10004, Extremadura, Spain
Tamara García, Department of Radiation Oncology, Hospital Universitario de Fuenlabrada, Fuenlabrada 28942, Madrid, Spain
Miriam López, Department of Radiation Oncology, Hospital Clínico Universitario Lozano Blesa, Zaragoza 50009, Aragón, Spain
Javier Serrano, Department of Radiation Oncology, Clínica Universidad de Navarra, Madrid 28027, Spain
Manuel Blanco, Department of Radiation Oncology, Hospital Universitario Torrecárdenas, Almería 04009, Andalucía, Spain
Raúl Hernanz, Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid 28034, Spain
Lourdes de Ingunza-Barón, Department of Radiation Oncology, Hospital Universitario Puerta del Mar, Cádiz 11009, Andalucía, Spain
Felipe Couñago, Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Hospital La Luz, Universidad Europea de Madrid, Madrid 28223, Spain
Author contributions: Rico M, Flamarique S, Casares C, García T, López M, Martínez M, Serrano J, Blanco M, Hernanz R, de Ingunza-Barón L, Marcos FJ and Couñago F contributed equally to this work; all authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mikel Rico, MD, PhD, Doctor, Department of Radiation Oncology, Complejo Hospitalario de Navarra, C/Irunlarrea 3, Pamplona 31008, Navarra, Spain. mikel.rico.oses@navarra.es
Received: December 24, 2020
Peer-review started: December 24, 2020
First decision: January 11, 2021
Revised: January 23, 2021
Accepted: March 9, 2021
Article in press: March 9, 2021
Published online: April 24, 2021
Abstract

Thymic epithelial tumours (TET) are rare, heterogeneous neoplasms that range from resectable indolent tumours to aggressive thymic carcinomas with a strong tendency to metastasize. The pathological diagnosis is complex, in part due to the existence of several different classification systems. The evidence base for the management of TETs is scant and mainly based on non-randomised studies and retrospective series. Consequently, the clinical management of TETs tends to be highly heterogenous, which makes it difficult to improve the evidence level. The role of technological advances in the field of radiotherapy and new systemic therapies in the treatment of TETs has received little attention to date. In the present clinical guidelines, developed by the GOECP/SEOR, we review recent developments in the diagnosis and classification of TETs. We also present a consensus-based therapeutic strategy for each disease stage that takes into consideration the best available evidence. These guidelines focus primarily on the role of radiotherapy, including recent advances, in the management of TETs. The main aim of this document is to promote the standardisation of clinical practice and lay the foundations for future studies to clarify the main unresolved questions related to the optimal management of TET.

Keywords: Targeted therapies, Thymic epithelial tumors, Radiotherapy, Reirradiation, Guidelines, Chemotherapy

Core Tip: Thymic epithelial tumours (TET) are rare, heterogeneous tumours. The clinical management of these tumours is largely based on studies with a low level of evidence. For this reason, it is especially important to develop guidelines to help guide the optimal approach to managing this disease. The present clinical guidelines review the main recommendations for the diagnosis and classification of TET, providing recommendations for the therapeutic approach based on the tumour stage and pathological anatomy. An important focus of these guidelines is the role of radiotherapy and novel therapies.