03/06/2017

NCCN has published updates to the NCCN Guidelines, NCCN Compendium®, and NCCN Imaging AUC™ for Thymomas and Thymic Carcinomas.

NCCN has published updates to the NCCN Guidelines, NCCN Compendium®, and NCCN Imaging AUC™ for Thymomas and Thymic Carcinomas. These NCCN Guidelines are currently available as Version 1.2017. 

• Initial Evaluation (THYM-1)
  • Footnote “a” added: “When assessing a mediastinal mass, detection of thymic malignancy versus thymic cyst can be better discriminated with chest MRI compared to chest CT, potentially avoiding an unnecessary thymectomy.”
• Postoperative Management (THYM-3)
  • R0 resection, Thymoma or thymic carcinoma, capsular invasion present stages II-IV: “Consider postoperative RT” changed from a category 2B to a category 2A recommendation.
  • Surveillance for Thymoma, no capsular invasion or thymic carcinoma, stage I: frequency for CT scan with contrast changed from every 6 months to every 6–12
• Principles of Radiation Therapy (THYM-B 2 of 3)
  • Radiation Techniques, bullet 4 modified: “In addition to following the normal tissue constraints recommendation using the Principles of RT for non-small cell lung cancer, more conservative limits are recommended to minimize the dose volumes to all the normal structures. Since these patients are younger and mostly long-term survivors, the mean total dose to the heart should be as low as reasonably achievable to potentially maximize survival.”
  • Radiation Techniques, bullet 5 added: “Proton beam therapy (PBT) has been shown to improve the dosimetry compared to IMRT allowing better sparing of the normal organs (lungs, heart, and esophagus). Additionally, favorable results in terms of both local control and toxicity have been obtained with PBT. Based on these data, PBT may be considered in certain circumstances.”

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium, the NCCN Biomarkers Compendium^®, the NCCN Chemotherapy Order Templates (NCCN Templates^®), and the NCCN Imaging AUC™, please visit NCCN.org.