Abstract: Objective：We retrospectively analysed 72 patients with malignant thymoma and discussed the efficacy of chemotherapy for stage Ⅳ thymoma, and the relationship between regimen choice and response rate of different chemotherapy regimen. Methods ：We retrospectively summarised 72 patients treated in our hospital for advanced malignant thymoma including 48 male and 24 female patients with PS≤2 from May 1999 to September 2008. Results ：All 72 patients had evaluabe disease, and response rate of first line platinum-based chemotherapy was 42.1%(27/64), while RR of non-platinum-based regimen was 25%(2/8).In single variate analysis of overall survival, survival rate of male patients was significantly lower than that of female （P=0.025); first line chemotherapy benefit group (CR+PR+SD) had significantly higher survival rate than progression (PD) group (P<0.001); survival rate of patients received chemotherapy alone was significantly lower than that of chemotherapy combined with local treatment (surgery or radiotherapy; P=0.004).Patients of different age, pathology, tumor sizes, metastatic sites, numbers of chemotherapy regimens and first line platinum-based regimen or non-platinum-based regimen had no statistical significant difference.However, in multi-variate analysis, numbers of chemotherapy regimens, effect of first line regimen and whether chemotherapy was combined with local treatment (surgery or radiotherapy) were essential prognostic factors.Primary adverse events of chemotherapy were neutropenia, anemia, GI events and abnormal liver function. Conclusion ：Chemotherapy is an essential and effective treatment method for advanced malignant thymoma, with tumor responses and survival improvement observed in a certain number of patients.Comprehensive application of multi-discipline treatment may benefit patients more effectively.