Combination chemotherapy in invasive thymoma. Role of COPP

Combination chemotherapy consisting of cyclophosphamide, vincristine, prednisone, and procarbazine (COPP) was administered to 5 patients with invasive lymphoepithelial thymoma. Objective evidence of tumor regression was seen in 4 patients. Given prior to preoperative radiation therapy, COPP produced partial remissions in 2 patients, making possible smaller radiation treatment fields. Two patients with pleural involvement when first seen, achieved tumor regression when COPP was given prior to radical radiation therapy. One of these patients remains disease-free at 34 months; the other succumbed to pneumonitis. One patient, presenting with pleural metastasis three years after undergoing incomplete resection of thymoma, failed to respond to treatment. Combination chemotherapy with COPP can produce objective regression of invasive lymphoepithelial thymomas which may be useful in the preoperative management of selected cases, as well as in the management of unresectable or metastatic disease.