Study on Intensity-Modulated Pleural Radiation Therapy (IMPRINT) for Thymic Cancer Spread to Lung and Chest Lining

Inclusion Criteria

• Must provide written consent to participate in the study.
• Have a confirmed diagnosis of thymic cancer, including thymic carcinoma.
• Have evidence of cancer spread to the pleura, either through imaging or pathology. This includes new stage IVA or returning disease in the pleura. Cancer in the lung fissure is allowed if it has been surgically removed.
• No cancer spread outside the chest or to the opposite side of the pleura or pericardium.
• Aged between 18 and 80 years old.
• Have a Karnofsky performance status of 80% or higher, indicating good general health.
• Meet specific lung function test requirements: DLCO over 40% and FEV1 at least 35%.
• Have a kidney function rate (GFR) of 50 mL/min/1.73 m2 or higher, calculated using a specific formula. If there are concerns about kidney function, an additional kidney scan may be done before radiation therapy.

Exclusion Criteria

• Need for continuous oxygen use.
• Recent severe flare-up of myasthenia gravis requiring new medication in the last 6 months.
• Previous removal of a kidney on the opposite side of the pleural cancer.
• Previous chest radiation that prevents the use of hemithoracic pleural IMRT. Radiation to the thymic area or pleura is allowed.
• Undergoing a specific type of lung surgery called extrapleural pneumonectomy. Other surgeries to remove pleural nodules or the primary thymic tumor are allowed.
• Recent hospitalization for heart failure within the last 30 days.
• Chronic obstructive pulmonary disease (COPD) requiring long-term oral steroids over 10 mg of prednisone daily. Inhaled steroids are allowed.
• Recent hospitalization for unstable angina or heart attack within the last 3 months.
• History of interstitial lung disease.
• Pregnant or breastfeeding women.
• Men or women not using effective birth control methods.