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Wu B, Zhang X, Feng N, Hu Z, Wu J, Zhou W, Wei Y, Zhang W, Wang K. Treatment strategies for stage IA non-small cell lung cancer: A SEER-based population study. PLoS One 2024; 19:e0298470. [PMID: 38683794 PMCID: PMC11057715 DOI: 10.1371/journal.pone.0298470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/24/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND There are various therapeutic methods for treating stage IA (T1N0M0) non-small cell lung cancer (NSCLC), but no studies have systematically assessed multiple treatments to determine the most effective therapy. METHODS Stage IA NSCLC patient data collected between 2004 and 2018 were gathered from the Surveillance, Epidemiology, and End Results (SEER) database. Treatment modalities included observation, chemotherapy alone (CA), radiation alone (RA), radiation+chemotherapy (RC), surgery alone (SA), surgery+chemotherapy (SC), surgery+radiation (SR) and surgery+radiation+chemotherapy (SRC). Comparisons were made of overall survival (OS) and lung cancer-specific survival (LCSS) among patients based on different therapeutic methods by survival analysis. RESULTS Ultimately, 89147 patients with stage IA NSCLC between 2004 and 2018 were enrolled in this study. The order of multiple treatment modalities based on the hazard ratio (HR) for OS for the entire cohort revealed the following results: SA (HR: 0.20), SC (HR: 0.25), SR (HR: 0.42), SRC (HR: 0.46), RA (HR: 0.56), RC (HR: 0.72), CA (HR: 0.91) (P<0.001), and observation (HR: Ref). The SA group had the best OS and LCSS, and similar results were found in most subgroup analyses (all P<0.001). The order of surgical modalities based on the HR for OS for the entire cohort revealed the following results: lobectomy (HR: 0.32), segmentectomy (HR: 0.41), wedge resection (HR: 0.52) and local tumor destruction (HR: Ref). Lobectomy had the best effects on OS and LCSS, and similar results were found in all subgroup analyses (all P<0.001). CONCLUSION SA appeared to be the optimal treatment modality for patients with stage IA NSCLC, and lobectomy was associated with the best prognosis. There may be some indication and selection bias in our study, and the results of this study should be confirmed in a prospective study.
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Affiliation(s)
- Bo Wu
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Xiang Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Nan Feng
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Zhuozheng Hu
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Jiajun Wu
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Weijun Zhou
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Yiping Wei
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Wenxiong Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Kang Wang
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
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Charalel RA, Datta S, Durack JC, Khilnani NM, Salem R, Spies JB, Kwan SW. Patient-Reported Outcomes: Updates since the 2017 Society of Interventional Radiology Foundation Research Consensus Panel. J Vasc Interv Radiol 2024; 35:497-505. [PMID: 38128720 DOI: 10.1016/j.jvir.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Affiliation(s)
- Resmi A Charalel
- Division of Interventional Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York; Department of Population Health Sciences, Weill Cornell Medicine, New York, New York.
| | - Sanjit Datta
- Division of Interventional Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York
| | | | - Neil M Khilnani
- Division of Interventional Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Riad Salem
- Division of Vascular and Interventional Radiology, Department of Radiology, Northwestern Medicine, Chicago, Illinois
| | - James B Spies
- Department of Radiology, MedStar Georgetown University Hospital, Washington, DC
| | - Sharon W Kwan
- Department of Radiology, Denver Health, Denver, Colorado
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Chang ATC, Ng CSH, Nezami N. Treatment strategies for malignant pulmonary nodule: beyond lobectomy. Point-counterpoint. Curr Opin Pulm Med 2024; 30:35-47. [PMID: 37916619 DOI: 10.1097/mcp.0000000000001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW Technological advancement in low-dose computed tomography resulted in an increased incidental discovery of early-stage lung cancer and multifocal ground glass opacity. The demand for parenchyma-preserving treatment strategies is greater now than ever. Pulmonary ablative therapy is a groundbreaking technique to offer local ablative treatment in a lung-sparing manner. It has become a promising technique in lung cancer management with its diverse applicability. In this article, we will review the current development of ablative therapy in lung and look into the future of this innovative technique. RECENT FINDINGS Current literature suggests that ablative therapy offers comparable local disease control to other local therapies and stereotactic body radiation therapy (SBRT), with a low risk of complications. In particular, bronchoscopic microwave ablation (BMWA) has considerably fewer pleural-based complications due to the avoidance of pleural puncture. BMWA can be considered in the multidisciplinary treatment pathway as it allows re-ablation and allows SBRT after BMWA. SUMMARY With the benefits which ablative therapy offers and its ability to incorporate into the multidisciplinary management pathway, we foresee ablative therapy, especially BMWA gaining significance in lung cancer treatment. Future directions on developing novel automated navigation platforms and the latest form of ablative energy would further enhance clinical outcomes for our patients.
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Affiliation(s)
- Aliss Tsz Ching Chang
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China
| | - Calvin S H Ng
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China
| | - Nariman Nezami
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine
- Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore
- The Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, University of Maryland, Colleague Park, , Maryland, USA
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4
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Peng J, Bie Z, Li Y, Guo R, Li X. Safety and efficacy of CT-guided percutaneous microwave ablation for stage I non-small cell lung cancer in patients with comorbid idiopathic pulmonary fibrosis. Eur Radiol 2023:10.1007/s00330-023-10510-9. [PMID: 38114848 DOI: 10.1007/s00330-023-10510-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/24/2023] [Accepted: 11/06/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES To evaluate the safety and efficacy of microwave ablation (MWA) for stage I non-small cell lung cancer (NSCLC) in patients with idiopathic pulmonary fibrosis (IPF). MATERIALS AND METHODS A retrospective single-center cohort study was conducted in patients with clinical stage I NSCLC who underwent CT-guided MWA from Nov 2016 to Oct 2021. The patients were divided into the IPF group and the non-IPF group. The primary endpoints were 90-day adverse events and hospital length of stay (HLOS). The secondary endpoints included overall survival (OS) and progression-free survival (PFS). RESULTS A total of 107 patients (27 with IPF and 80 without IPF) were finally included for analysis. No procedure-related acute exacerbation of IPF or death occurred post-MWA. The rates of adverse events were similar between the groups (48.6% vs. 47.7%; p = 0.998). The incidence of grade 3 adverse events in the IPF group was higher than that in the non-IPF group without a significant difference (13.5% vs. 4.6%; p = 0.123). Median HLOS was 5 days in both groups without a significant difference (p = 0.078). The 1-year and 3-year OS were 85.2%/51.6% in the IPF group, and 97.5%/86.4% in the non-IPF group. The survival of patients with IPF was significantly poorer than the survival of patients without IPF (p < 0.001). There was no significant difference for PFS (p = 0.271). CONCLUSION MWA was feasible in the treatment of stage I NSCLC in patients with IPF. IPF had an adverse effect on the survival of stage I NSCLC treated with MWA. CLINICAL RELEVANCE STATEMENT CT-guided microwave ablation is a well-tolerated and effective potential alternative treatment for stage I non-small cell lung cancer in patients with idiopathic pulmonary fibrosis. KEY POINTS • Microwave ablation for stage I non-small cell lung cancer was well-tolerated without procedure-related acute exacerbation of idiopathic pulmonary fibrosis and death in patients with idiopathic pulmonary fibrosis. • No differences were observed in the incidence of adverse events between patients with idiopathic pulmonary fibrosis and those without idiopathic pulmonary fibrosis after microwave ablation (48.6% vs. 47.7%; p = 0.998). • The 1-year and 3-year overall survival rates (85.2%/51.6%) in the idiopathic pulmonary fibrosis group were worse than those in the non- idiopathic pulmonary fibrosis group (97.5%/86.4%) (p < 0.001).
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Affiliation(s)
- JinZhao Peng
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Street, Beijing, 100730, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100370, China
| | - ZhiXin Bie
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Street, Beijing, 100730, China
| | - YuanMing Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Street, Beijing, 100730, China
| | - RunQi Guo
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Street, Beijing, 100730, China
| | - XiaoGuang Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan Dahua Street, Beijing, 100730, China.
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100370, China.
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Marguerit A, Azria D, Riou O, Demontoy S, Thezenas S, Boisselier P. [Stereotactic Body Radiation Therapy for less than 3cm (stage I) and 5cm (stage II) inoperable lung tumors: 10 years experience of Montpellier Cancer Institute]. Cancer Radiother 2023; 27:387-397. [PMID: 37537027 DOI: 10.1016/j.canrad.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/30/2023] [Accepted: 05/04/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE Search for predictive factors on survival and local control for less than 3 centimeters (cm) (stage I) and 5cm (stage II) inoperable lung tumors treated by Stereotactic Body Radiation Therapy (SBRT) in a retrospective monocentric study from Montpellier Cancer Institute (ICM) PATIENTS AND METHOD: Every patients treated at ICM for a stage I or II inoperable lung tumors from 2009 to 2019 were analyzed. RESULTS One hundred and seventy nine lesions were treated in 176 patients, with a major part (82,7%) in operated due to chronic obstructive pulmonary disease. Median overall survival for all patients was 71,7 months with a 35 months follow-up and the 2 years loco-regional free survival was 94,0 months. Better associated outcomes were stage I (median overall survival 71,7 versus 29,0 months P=0,004 ; HR=2,37 P=0,005), BED≥150Gy (median time-to-progression not reached versus 76,7 months P=0,025), small size of Planning Target Volume (PTV) (HR=0,42 P=0,032 when PTV<15,6 cc). 7,3% of all patients developed radiation pneumonitis. CONCLUSION SBRT is associated with an excellent overall survival and a high rate of local control for less than 3cm (stage I) and 5cm (stage II) lung tumors but a low rate of toxicities. For these patients with many comorbidities, BED over 150Gy seems to be associated with a better loco-regional free survival, while cause of death is often other than lung cancer.
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Affiliation(s)
- A Marguerit
- Service d'oncologie-radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France.
| | - D Azria
- Service d'oncologie-radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France
| | - O Riou
- Service d'oncologie-radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France
| | - S Demontoy
- Service d'oncologie-radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France
| | - S Thezenas
- Service de statistiques, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France
| | - P Boisselier
- Service d'oncologie-radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France
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Lassandro G, Picchi SG, Corvino A, Gurgitano M, Carrafiello G, Lassandro F. Ablation of pulmonary neoplasms: review of literature and future perspectives. Pol J Radiol 2023; 88:e216-e224. [PMID: 37234463 PMCID: PMC10207320 DOI: 10.5114/pjr.2023.127062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/17/2023] [Indexed: 05/28/2023] Open
Abstract
Thermal ablation is a minimally invasive technology used to treat many types of tumors, including lung cancer. Specifically, lung ablation has been increasingly performed for unsurgical fit patients with both early-stage primi-tive lung cancer and pulmonary metastases. Image-guided available techniques include radiofrequency ablation, microwave ablation, cryoablation, laser ablation and irreversible electroporation. Aim of this review is to illustrate the major thermal ablation modalities, their indications and contraindications, complications, outcomes and notably the possible future challenges.
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Affiliation(s)
- Giulia Lassandro
- Department of Radiology, Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | | | - Antonio Corvino
- Movement Sciences and WellbeingDepartment, University of Naples "Parthenope", Naples, Italy
| | - Martina Gurgitano
- Operative Unit of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Gianpaolo Carrafiello
- Operative Unit of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Francesco Lassandro
- Department of Radiology, MonaldiHospital, AziendaOspedaliera dei Colli, Naples, Italy
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7
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Claes E, Wener R, Neyrinck AP, Coppens A, Van Schil PE, Janssens A, Lapperre TS, Snoeckx A, Wen W, Voet H, Verleden SE, Hendriks JMH. Innovative Invasive Loco-Regional Techniques for the Treatment of Lung Cancer. Cancers (Basel) 2023; 15:cancers15082244. [PMID: 37190172 DOI: 10.3390/cancers15082244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Surgical resection is still the standard treatment for early-stage lung cancer. A multimodal treatment consisting of chemotherapy, radiotherapy and/or immunotherapy is advised for more advanced disease stages (stages IIb, III and IV). The role of surgery in these stages is limited to very specific indications. Regional treatment techniques are being introduced at a high speed because of improved technology and their possible advantages over traditional surgery. This review includes an overview of established and promising innovative invasive loco-regional techniques stratified based on the route of administration, including endobronchial, endovascular and transthoracic routes, a discussion of the results for each method, and an overview of their implementation and effectiveness.
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Affiliation(s)
- Erik Claes
- ASTARC (Antwerp Surgical Training, Anatomy and Research Centre), University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Reinier Wener
- Department of Pulmonology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Arne P Neyrinck
- Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Anesthesia and Algology Unit, Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Axelle Coppens
- ASTARC (Antwerp Surgical Training, Anatomy and Research Centre), University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Paul E Van Schil
- ASTARC (Antwerp Surgical Training, Anatomy and Research Centre), University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Annelies Janssens
- Department of Thoracic Oncology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Thérèse S Lapperre
- Department of Pulmonology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- LEMP (Laboratory of Experimental Medicine and Pediatrics), University Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Annemiek Snoeckx
- Faculty of Medicine and Health Sciences, University Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- Department of Radiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Wen Wen
- Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Hanne Voet
- Department of Pulmonology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- LEMP (Laboratory of Experimental Medicine and Pediatrics), University Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Stijn E Verleden
- ASTARC (Antwerp Surgical Training, Anatomy and Research Centre), University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Department of Pulmonology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Jeroen M H Hendriks
- ASTARC (Antwerp Surgical Training, Anatomy and Research Centre), University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
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8
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Daly ME, Beagen P, Madani MH. Nonsurgical Therapy for Early-Stage Lung Cancer. Hematol Oncol Clin North Am 2023; 37:499-512. [PMID: 37024386 DOI: 10.1016/j.hoc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Treatment options for medically inoperable, early-stage non-small cell lung cancer (NSCLC) include stereotactic ablative radiotherapy (SABR) and percutaneous image guided thermal ablation. SABR is delivered over 1-5 sessions of highly conformal ablative radiation with excellent tumor control. Toxicity is depending on tumor location and anatomy but is typically mild. Studies evaluating SABR in operable NSCLC are ongoing. Thermal ablation can be delivered via radiofrequency, microwave, or cryoablation, with promising results and modest toxicity. We review the data and outcomes for these approaches and discuss ongoing studies.
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Stereotactic Body Radiation Therapy Versus Ablation Versus Surgery for Early-Stage Lung Cancer in High-Risk Patients. Thorac Surg Clin 2023; 33:179-187. [PMID: 37045487 DOI: 10.1016/j.thorsurg.2023.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Current treatment for early-stage lung cancer focuses on surgical intervention as the mainstay of treatment; however, this poses issues in patients that are high-risk or unable to tolerate any operation. In this case, sublobar resection or radiation therapy has been the primary treatment for these subsets of patients. Alternative approaches include stereotactic body radiation therapy (SBRT) and thermal ablation. In this article, we focus on treatment strategies using SBRT, thermal ablation, or surgery as it pertains to high-risk patients with early-stage lung cancer.
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Bartlett EC, Rahman S, Ridge CA. Percutaneous image-guided thermal ablation of lung cancer: What is the evidence? Lung Cancer 2023; 176:14-23. [PMID: 36571982 DOI: 10.1016/j.lungcan.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Thermal ablation techniques have now been used for more than twenty years in the treatment of primary lung tumours, predominantly non-small cell lung cancer (NSCLC). Although primarily used for the treatment of early-stage disease in non-surgical patients, thermal ablation is now also being used in selected patients with oligometastatic and oligoprogressive disease. This review discusses the techniques available for thermal ablation, the evidence for use of thermal ablation in primary lung tumours in early- and advanced-stage disease and compares thermal ablation to alternative treatment strategies.
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Affiliation(s)
- E C Bartlett
- Royal Brompton Hospital (Guy's and St Thomas' NHS Foundation Trust), Department of Radiology, Sydney Street, London SW3 6NP, United Kingdom.
| | - S Rahman
- Royal Brompton Hospital (Guy's and St Thomas' NHS Foundation Trust), Department of Radiology, Sydney Street, London SW3 6NP, United Kingdom
| | - C A Ridge
- Royal Brompton Hospital (Guy's and St Thomas' NHS Foundation Trust), Department of Radiology, Sydney Street, London SW3 6NP, United Kingdom; National Heart and Lung Institute, Imperial College, London SW3 6LY, United Kingdom
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11
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Liu J, Wang C, Yi W, Zheng H, Zheng A. A retrospective comparative study of microwave ablation and sublobectomy in the treatment of early subpleural nonsmall cell lung cancer. Int J Hyperthermia 2022; 39:1379-1386. [DOI: 10.1080/02656736.2022.2136410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Jianwei Liu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong First Medical University, Jinan, China
| | - Caixia Wang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Weiwei Yi
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hang Zheng
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Aimin Zheng
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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12
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Determination of Interactive States of Immune Checkpoint Regulators in Lung Metastases after Radiofrequency Ablation. Cancers (Basel) 2022; 14:cancers14235738. [PMID: 36497220 PMCID: PMC9737190 DOI: 10.3390/cancers14235738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cases of the spontaneous regression of multiple pulmonary metastases, after radiofrequency ablation (RFA), of a single lung metastasis, have been documented to be mediated by the immune system. The interaction of immune checkpoints, e.g., PD-1/PD-L1 and CTLA-4/CD80, may explain this phenomenon. The purpose of this study is to identify and quantify immune mechanisms triggered by RFA of pulmonary metastases originating from colorectal cancer. METHODS We used two-site time-resolved Förster resonance energy transfer as determined by frequency-domain FLIM (iFRET) for the quantification of receptor-ligand interactions. iFRET provides a method by which immune checkpoint interaction states can be quantified in a spatiotemporal manner. The same patient sections were used for assessment of ligand-receptor interaction and intratumoral T-cell labeling. CONCLUSION The checkpoint interaction states quantified by iFRET did not correlate with ligand expression. We show that immune checkpoint ligand expression as a predictive biomarker may be unsuitable as it does not confirm checkpoint interactions. In pre-RFA-treated metastases, there was a significant and negative correlation between PD-1/PD-L1 interaction state and intratumoral CD3+ and CD8+ density. The negative correlation of CD8+ and interactive states of PD-1/PD-L1 can be used to assess the state of immune suppression in RFA-treated patients.
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13
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Lau KK, Steinke K, Reis S, Cherukuri SP, Cejna M. Current trends in image-guided chest interventions. Respirology 2022; 27:581-599. [PMID: 35758539 PMCID: PMC9545252 DOI: 10.1111/resp.14315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/18/2022] [Indexed: 02/06/2023]
Abstract
Interventional radiology (IR) is a rapidly expanding medical subspecialty and refers to a range of image‐guided procedural techniques. The image guidance allows real‐time visualization and precision placement of a needle, catheter, wire and device to deep body structures through small incisions. Advantages include reduced risks, faster recovery and shorter hospital stays, lower costs and less patient discomfort. The range of chest interventional procedures keeps on expanding due to improved imaging facilities, better percutaneous assess devices and advancing ablation and embolization techniques. These advances permit procedures to be undertaken safely, simultaneously and effectively, hence escalating the role of IR in the treatment of chest disorders. This review article aims to cover the latest developments in some image‐guided techniques of the chest, including thermal ablation therapy of lung malignancy, targeted therapy of pulmonary embolism, angioplasty and stenting of mediastinal venous/superior vena cava occlusion, pulmonary arteriovenous malformation treatment and bronchial artery embolization for haemoptysis.
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Affiliation(s)
- Kenneth K Lau
- Monash Imaging, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Karin Steinke
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,University of Queensland School of Medicine, St Lucia, Queensland, Australia
| | - Stephen Reis
- Division of Interventional Radiology, Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Srinivas P Cherukuri
- Division of Interventional Radiology, Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Manfred Cejna
- Institute for Diagnostic and Interventional Radiology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
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Criner GJ, Agusti A, Borghaei H, Friedberg J, Martinez FJ, Miyamoto C, Vogelmeier CF, Celli BR. Chronic Obstructive Pulmonary Disease and Lung Cancer: A Review for Clinicians. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2022; 9:454-476. [PMID: 35790131 PMCID: PMC9448004 DOI: 10.15326/jcopdf.2022.0296] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) and lung cancer are common global causes of morbidity and mortality. Because both diseases share several predisposing risks, the 2 diseases may occur concurrently in susceptible individuals. The diagnosis of COPD has important implications for the diagnostic approach and treatment options if lesions concerning for lung cancer are identified during screening. Importantly, the presence of COPD has significant implications on prognosis and management of patients with lung cancer. In this monograph, we review the mechanistic linkage between lung cancer and COPD, the impact of lung cancer screening on patients at risk, and the implications of the presence of COPD on the approach to the diagnosis and treatment of lung cancer. This manuscript succinctly reviews the epidemiology and common pathogenetic factors for the concurrence of COPD and lung cancer. Importantly for the clinician, it summarizes the indications, benefits, and complications of lung cancer screening in patients with COPD, and the assessment of risk factors for patients with COPD undergoing consideration of various treatment options for lung cancer.
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Affiliation(s)
- Gerard J. Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Alvar Agusti
- Cátedra Salud Respiratoria, University of Barcelona; Respiratory Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigacion Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Hossein Borghaei
- Department of Medical Oncology, Fox Chase Cancer Center at Temple University, Philadelphia, Pennsylvania, United States
| | - Joseph Friedberg
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | | | - Curtis Miyamoto
- Department of Radiation Oncology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
| | - Claus F. Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University Marburg, German Centre for Lung Research, Marburg, Germany
| | - Bartolome R. Celli
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States
- Harvard Medical School, Boston, Massachusetts, United States
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15
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Park HS, Detterbeck FC, Madoff DC, Bade BC, Kumbasar U, Mase VJ, Li AX, Blasberg JD, Woodard GA, Brandt WS, Decker RH. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation-part 4: systematic review of evidence involving SBRT and ablation. J Thorac Dis 2022; 14:2412-2436. [PMID: 35813762 PMCID: PMC9264060 DOI: 10.21037/jtd-21-1826] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/09/2022] [Indexed: 11/06/2022]
Abstract
Background Clinical decision-making for patients with stage I lung cancer is complex. It involves multiple options [lobectomy, segmentectomy, wedge, stereotactic body radiotherapy (SBRT), thermal ablation], weighing multiple outcomes (e.g., short-, intermediate-, long-term) and multiple aspects of each (e.g., magnitude of a difference, the degree of confidence in the evidence, and the applicability to the patient and setting at hand). A structure is needed to summarize the relevant evidence for an individual patient and to identify which outcomes have the greatest impact on the decision-making. Methods A PubMed systematic review from 2000-2021 of outcomes after SBRT or thermal ablation vs. resection is the focus of this paper. Evidence was abstracted from randomized trials and non-randomized comparisons with at least some adjustment for confounders. The analysis involved careful assessment, including characteristics of patients, settings, residual confounding etc. to expose degrees of uncertainty and applicability to individual patients. Evidence is summarized that provides an at-a-glance overall impression as well as the ability to delve into layers of details of the patients, settings and treatments involved. Results Short-term outcomes are meaningfully better after SBRT than resection. SBRT doesn't affect quality-of-life (QOL), on average pulmonary function is not altered, but a minority of patients may experience gradual late toxicity. Adjusted non-randomized comparisons demonstrate a clinically relevant detriment in long-term outcomes after SBRT vs. surgery. The short-term benefits of SBRT over surgery are accentuated with increasing age and compromised patients, but the long-term detriment remains. Ablation is associated with a higher rate of complications than SBRT, but there is little intermediate-term impact on quality-of-life or pulmonary function tests. Adjusted comparisons show a meaningful detriment in long-term outcomes after ablation vs. surgery; there is less difference between ablation and SBRT. Conclusions A systematic, comprehensive summary of evidence regarding Stereotactic Body Radiotherapy or thermal ablation vs. resection with attention to aspects of applicability, uncertainty and effect modifiers provides a foundation for a framework for individualized decision-making.
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Affiliation(s)
- Henry S. Park
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Frank C. Detterbeck
- Department of Thoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - David C. Madoff
- Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Brett C. Bade
- Department of Pulmonary Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Ulas Kumbasar
- Department of Thoracic Surgery, Hacettepe University School of Medicine, Ankara, Turkey
| | - Vincent J. Mase
- Department of Thoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Andrew X. Li
- Department of General Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Justin D. Blasberg
- Department of Thoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Gavitt A. Woodard
- Department of Thoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Whitney S. Brandt
- Department of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Roy H. Decker
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA
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16
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Cramer P, Pua BB. The Latest on Lung Ablation. Semin Intervent Radiol 2022; 39:285-291. [PMID: 36062233 PMCID: PMC9433157 DOI: 10.1055/s-0042-1753526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Lung cancer is the second most common cancer in both men and women. Despite smoking cessation efforts and advances in lung cancer detection and treatment, long-term survival remains low. For early-stage primary lung carcinoma, surgical resection offers the best chance of long-term survival; however, only about one-third of patients are surgical candidates. For nonsurgical candidates, minimally invasive percutaneous thermal ablation therapies have become recognized as safe and effective treatment alternatives, including radiofrequency ablation, microwave ablation, and cryoablation. Lung ablation is also an acceptable treatment for limited oligometastatic and oligorecurrent diseases. This article discusses the technologies and techniques available for tumor ablation of thoracic malignancies, as well as new treatments on the horizon.
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Affiliation(s)
- Peyton Cramer
- Division of Interventional Radiology, Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York
| | - Bradley B. Pua
- Division of Interventional Radiology, Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York
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17
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Daniel Humberto Pozza, Ramon Bezerra Andrade de Mello. Treatment Sequencing Strategies in Lung Cancer. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2022; 25:323-336. [PMID: 35599008 PMCID: PMC9127753 DOI: 10.3779/j.issn.1009-3419.2022.104.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND The advances in the lung cancer screening methods and therapeutics, together with awareness towards deleterious habits, such as smoking, is increasing the overall survival with better quality of life for the patients. However, lung cancer is still one of the most common and fatal neoplasm with a high incidence and consequently burden to public health worldwide. Thus, based on guidelines and recent phases II and III clinical trials studies, this manuscript summarizes the current treatment sequencing strategies in lung cancer. METHODS A comprehensive search of related articles was performed focused on phases II and III clinical trials studies. RESULTS The lung cancer management should take into consideration the tumor characteristics, histology, molecular pathology and be discussed in a multidisciplinary team. Lung cancer treatment options comprises surgery whenever possible, radiotherapy associate with/or chemotherapy and immunotherapy as monotherapy, or combined with chemotherapy and best palliative care. CONCLUSIONS The screening predictability in more patients, smoking reduction, early diagnosis, better disease understanding and individualized, more effective and tolerable therapeutics are related to an increasing in overall survival and quality of life. In the near future improvement of personalized therapy in precision medicine is expected, enhancing new predictive biomarkers, optimal doses and optimal treatment sequencing as well as anti-cancer vaccines development.
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Affiliation(s)
- Daniel Humberto Pozza
- Department of Biomedicine, Faculty of Medicine and i3s, University of Porto, 4200-319 Porto, Portugal,Daniel Humberto Pozza, E-mail:
| | - Ramon Bezerra Andrade de Mello
- Discipline of Medical Oncology, Post-graduation Program in Medicine, Nine of July University (UNINOVE), São Paulo, Brazil./Nine of July Hospital, São Paulo, Brazil
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18
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Early enlarging cavitation after percutaneous radiofrequency ablation of lung tumors: Incidence, risk factors and outcome. Diagn Interv Imaging 2022; 103:464-471. [DOI: 10.1016/j.diii.2022.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023]
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19
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Zhang R, Kang J, Ren S, Xing L, Xu Y. Comparison of stereotactic body radiotherapy and radiofrequency ablation for early-stage non-small cell lung cancer: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:104. [PMID: 35282118 PMCID: PMC8848429 DOI: 10.21037/atm-21-6256] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/12/2022] [Indexed: 12/25/2022]
Abstract
Background Stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) are recommended for patients with inoperable early-stage non-small cell lung cancer (NSCLC), with both offering promising results. However, it is largely unknown which of these two treatment modalities provides superior benefits for patients. Therefore, this systematic review and meta-analysis compared clinical outcomes and safety between SBRT and RFA in patients with inoperable early-stage NSCLC. Methods Eligible studies published between 2001 and 2020 were obtained through a comprehensive search of the PubMed, Medline, Embase, and Cochrane Library databases. Original English-language studies on the treatment of early-stage NSCLC with SBRT or RFA were included. Local control (LC) rates, overall survival (OS) rates, and adverse events were obtained by pooled analyses. Results Eighty-seven SBRT studies (12,811 patients) and 18 RFA studies (1,535 patients) met the eligibility criteria. For SBRT, the LC rates (with 95% confidence intervals) at 1, 2, 3, and 5 years were 98% (97-98%), 95% (95-96%), 92% (91-93%), and 92% (91-93%), respectively, which were significantly higher than those for RFA [75% (69-82%), 31% (22-39%), 67% (58-76%), and 41% (30-52%), respectively] (P<0.01). There were no significant differences in short-term OS between SBRT and RFA [1-year OS rate: 87% (86-88%) versus 89% (88-91%), P=0.07; 2-year OS rate: 71% (69-72%) versus 69% (64-74%), P=0.42]. Regarding long-term OS, the 3- and 5-year OS rates for SBRT were 58% (56-59%) and 39% (37-40%), respectively, which were significantly (P<0.01) superior to those for RFA [48% (45-51%) and 21% (19-23%), respectively]. The most common complication of SBRT was radiation pneumonitis (grade ≥2), making up 9.1% of patients treated with SBRT, while pneumothorax was the most common complication of RFA, making up 27.2% of patients treated with RFA. Discussion Compared with RFA, SBRT has superior LC and long-term OS rates but similar short-term OS rates. Prospective randomized trials with large sample sizes comparing the efficacy of SBRT and RFA are warranted.
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Affiliation(s)
- Ran Zhang
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.,Department of Medical Oncology, Shanghai Pulmonary Hospital & Institute of Thoracic Cancer, School of Medicine, Tongji University, Shanghai, China
| | - Jingjing Kang
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Institute of Thoracic Cancer, School of Medicine, Tongji University, Shanghai, China
| | - Ligang Xing
- Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Yaping Xu
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
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20
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Microwave ablation treatment for medically inoperable stage I non-small cell lung cancers: long-term results. Eur Radiol 2022; 32:5616-5622. [PMID: 35226157 DOI: 10.1007/s00330-022-08615-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVES In the present study, we aim to show the results of microwave ablation (MWA) for medically inoperable stage I non-small cell lung cancers (NSCLCs) with long-term follow-up. METHODS From Feb 2011 to Mar 2016, patients with histologically proven clinical stage I NSCLC were treated with CT-guided MWA and retrospectively analyzed. The primary end point was overall survival (OS). Secondary end points included disease-free survival (DFS), cancer-specific survival (CSS), and complications. RESULTS A total of 105 patients with 105 lesions underwent MWA. The mean age was 70.7 years (range: 40-86 years), and the mean diameter of all lesions was 2.40 cm (range: 0.9-4.0 cm). Adenocarcinoma was the most common histological type (77, 73.3%), followed by squamous cell carcinomas (21, 20%) and undefined NSCLC (7, 6.7%). With a median follow-up of 54.8 months, the median DFS was 36.0 months, and 1-, 3-, and 5-year DFS rates were 89.5%, 49.4%, and 42.7%, respectively. The median CSS and OS were 89.8 and 64.2 months, respectively. The OS rate was 99% at 1 year, 75.6% at 3 years, and 54.1% at 5 years, while the CSS rates were 99%, 78.9%, and 60.9%, respectively. Patients with stage IB lesions had significant shorter DFS (22.3 months vs. undefined, HR: 11.5, 95%CI: 5.85-22.40) and OS (37.3 vs. 89.8 months, HR: 8.64, 95% CI: 4.49-16.60) than IA disease. CONCLUSION MWA is a safe, effective, and potentially curative therapy for medically inoperable stage I NSCLC patients. KEY POINTS • In this multicenter retrospective study which included 105 patients, we found the median overall survival (OS) was 64.2 months. The OS rate was 99% at 1 year, 75.6% at 3 years, and 54.1% at 5 years. • Procedures were technically successful and well tolerated in all patients. Most MWA complications were mild or moderate.
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21
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Zhang N, Wu Y, Xu W, Li Z, Wang L. Synergic fabrication of multifunctional liposomes nanocomposites for improved radiofrequency ablation combination for liver metastasis cancer therapy. Drug Deliv 2022; 29:506-518. [PMID: 35147065 PMCID: PMC8845112 DOI: 10.1080/10717544.2021.2008056] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The field of biomedical research has recently been interested in nanoplatforms with various functionalities, such as cancer drug carriers and MRI and optical imaging, as well as thermal treatment, among other things. As a result of the present investigation, a unique multifunctional liposome (MFL) was established in this investigation. Using radiofrequency-induced imaging and drug release based on magnetic field impact, a dual drug delivery targeted with tumor multi-mechanism treatment was made more effective. The C60 (fullerene) surface was coated with iron nanocomposites to establish the proposed nanosystems, and PEGylation was used (Fe3O4-C60-PEG2000). For fullerene radiofrequency-triggered drug release, thermosensitive DPPC liposomes with folate-DSPE-PEG2000 enveloped the binary nanosystems and doxorubicin (DOX). The in vitro cytotoxicity of the nanocomposites was confirmed by the liver metastasis in HT-29 colon cancer cells using radiofrequency. The flow cytometry analysis confirmed the apoptosis cell death mechanism. The thermal treatment combined chemotherapeutic MFL nano framework transformed radiofrequency radiation from thermoresponsive liposomes, which was noticed both in vivo and in vitro. Due to their superior active tumor targeting and magnetic targeting characteristics, the MFL could also selectively destroy cancerous liver cells in highly co-localized targets.
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Affiliation(s)
- Ning Zhang
- Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yibin Wu
- Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Weiqi Xu
- Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Zhenjian Li
- 3D Biomedicine Science & Technology Co., Limited, Shanghai, China
| | - Lu Wang
- Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
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Cilleruelo-Ramos A, Cladellas-Gutiérrez E, de la Pinta C, Quintana-Cortés L, Sosa-Fajardo P, Couñago F, Mielgo-Rubio X, Trujillo-Reyes JC. Advances and controversies in the management of early stage non-small cell lung cancer. World J Clin Oncol 2021; 12:1089-1100. [PMID: 35070733 PMCID: PMC8716990 DOI: 10.5306/wjco.v12.i12.1089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/20/2021] [Accepted: 12/10/2021] [Indexed: 02/06/2023] Open
Abstract
Complete resection continues to be the gold standard for the treatment of early-stage lung cancer. The landmark Lung Cancer Study Group trial in 1995 established lobectomy as the minimum intervention necessary for the management of early-stage non-small cell lung cancer, as it was associated with lower recurrence and metastasis rates than sublobar resection and lower postoperative morbidity and mortality than pneumonectomy. There is a growing tendency to perform sublobar resection in selected cases, as, depending on factors such as tumor size, histologic subtype, lymph node involvement, and resection margins, it can produce similar oncological results to lobectomy. Alternative treatments such as stereotactic body radiotherapy and radiofrequency ablation can also produce good outcomes in inoperable patients or patients who refuse surgery.
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Affiliation(s)
- Angel Cilleruelo-Ramos
- Department of Thoracic Surgery, Clinic Universitary Hospital, Valladolid 47005, Spain
- Department of Surgery, Universidad de Valladolid, Valladolid 47001, Spain
| | | | - Carolina de la Pinta
- Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid 28034, Spain
| | - Laura Quintana-Cortés
- Department of Medical Oncology, Hospital Don Benito-Villanueva, Badajoz 06400, Spain
| | - Paloma Sosa-Fajardo
- Department of Radiation Therapy, Complejo Hospitalario Universitario, Santiago de Compostela, La Coruña 15706, Spain
| | - Felipe Couñago
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Madrid 28223, Spain
- Department of Radiation Oncology, Hospital La Luz, Madrid 28223, Spain
- Department of Medicine, School of Biomedical Sciences, Universidad Europea, Madrid 28223, Spain
| | - Xabier Mielgo-Rubio
- Department of Medical Oncology Unit, Hospital Universitario Fundación Alcorcón, Madrid 28922, Spain
| | - Juan Carlos Trujillo-Reyes
- Department of Thoracic Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona 08029, Spain
- Department of Surgery, Universitat Autónoma, Barcelona 08029, Spain
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Hsp70 Promotes SUMO of HIF-1 α and Promotes Lung Cancer Invasion and Metastasis. JOURNAL OF ONCOLOGY 2021; 2021:7873085. [PMID: 34868316 PMCID: PMC8642011 DOI: 10.1155/2021/7873085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 12/25/2022]
Abstract
Objective This study aims to investigate the effect of heat shock protein-70 (Hsp70) on epithelial-mesenchymal transition (EMT) of lung cancer cells under heat stimulation and to explore its possible molecular mechanism. Methods qRT-PCR and immunohistochemistry assay were used to detect the expression of Hsp70 in lung cancer tissues and adjacent tissues. EdU assay was used to detect the cell activity. The effect of Hsp70 on the migration and invasion of A549 and NCI-H446 cells was detected by the wound-healing assay and Transwell assay. A tumor transplantation animal model was established to detect the effect of overexpression of Hsp70 on proliferation and metastasis of lung cancer cells. Western blot assay was used to detect the effect of thermal stimulation and overexpression of Hsp70 on SUMO modification of HIF-1α. Results The wound-healing rate of A549 and NCI-H446 cells under Hsp70 stimulation was significantly higher than blank control group. At the same time, the number of cells passing through the membrane increased significantly. Hypodermic tumor transplantation in nude mice proved that knockout Hsp70 can inhibit proliferation and metastasis of lung cancer cells. Thermal stimulation upregulated the expression of Hsp70 and promoted SUMO modification of HIF-1α, ultimately promoting the proliferation and metastasis of lung cancer. Inhibition of Hsp70 reverses the effect of thermal stimulation on lung cancer by reducing the SUMO modification of HIF-1α. Conclusion Thermal stimulation can promote EMT in A549 and NCI-H446 cells and promote cell migration and invasion in vitro and in vivo by upregulation of Hsp70. This process is associated with the promotion of SUMO modification of HIF-1α.
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Zheng X, Yuan H, Gu C, Yang C, Xie F, Zhang X, Xu B, Sun J. Transbronchial lung parenchyma cryoablation with a novel flexible cryoprobe in an in vivo porcine model. Diagn Interv Imaging 2021; 103:49-57. [PMID: 34593335 DOI: 10.1016/j.diii.2021.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/16/2021] [Accepted: 08/31/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the feasibility and safety of transbronchial cryoablation with a novel flexible cryoprobe using nitrogen as the refrigerant in an in vivo porcine model of lung parenchyma. MATERIALS AND METHODS A novel flexible cryoprobe using nitrogen as the refrigerant was used for transbronchial cryoablation of lung parenchyma in six normal female pigs. The cryoprobe was delivered to the distal bronchus in the bilateral porcine lungs via the bronchoscopic working channel under virtual bronchoscopy guidance. The position was confirmed with real-time computed tomography (CT). The whole procedure included two freeze-thaw cycles (15 min and 2 min, respectively). CT images were obtained during cryoablation and at 24 h, one week, two weeks and four weeks after the treatment to assess the effectiveness and safety of the procedure. Ablation zone tissue samples were obtained at 24 h and four weeks after the cryoablation for further histopathological analysis. RESULTS All ablation procedures (12/12; 100%) were performed successfully. No major complications occurred during the procedure or the observation period. The ablation zones were clearly depicted on CT with a maximal ablation zone volume at 24 h (21.88 ± 12.61 [SD] cm3) compared to 3.64 ± 2.06 (SD) cm3 and 10.73 ± 3.84 (SD) cm3 at the end of the 1st and 2nd freeze-thaw cycles, respectively (P < 0.001). Histopathological analysis revealed that a coagulative necrotic zone was formed along the target bronchus, with obvious vascular occlusion and hemorrhage 24 h after treatment. The lesions gradually formed fibrosis after four weeks. CONCLUSION The novel flexible bronchoscopy-guided cryoablation is a feasible, safe and effective modality in an in vivo porcine model of peripheral normal lung parenchyma, suggesting potential capabilities for the treatment of peripheral lung cancer in humans.
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Affiliation(s)
- Xiaoxuan Zheng
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Haibin Yuan
- Department of Emergency, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China
| | - Chuanjia Gu
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Chi Yang
- Research and Development Department, AccuTarget MediPharma (Shanghai) Co., Ltd., 201318 Shanghai, China; School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, 200093 Shanghai, China
| | - Fangfang Xie
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Xueyan Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China
| | - Binkai Xu
- Research and Development Department, AccuTarget MediPharma (Shanghai) Co., Ltd., 201318 Shanghai, China; School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, 200093 Shanghai, China
| | - Jiayuan Sun
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China.
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25
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Li M, Hao B, Zhang M, Reiter RJ, Lin S, Zheng T, Chen X, Ren Y, Yue L, Abay B, Chen G, Xu X, Shi Y, Fan L. Melatonin enhances radiofrequency-induced NK antitumor immunity, causing cancer metabolism reprogramming and inhibition of multiple pulmonary tumor development. Signal Transduct Target Ther 2021; 6:330. [PMID: 34471091 PMCID: PMC8410827 DOI: 10.1038/s41392-021-00745-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/20/2021] [Accepted: 08/16/2021] [Indexed: 12/17/2022] Open
Abstract
Surgery is the common treatment for early lung cancer with multiple pulmonary nodules, but it is often accompanied by the problem of significant malignancy of other nodules in non-therapeutic areas. In this study, we found that a combined treatment of local radiofrequency ablation (RFA) and melatonin (MLT) greatly improved clinical outcomes for early lung cancer patients with multiple pulmonary nodules by minimizing lung function injury and reducing the probability of malignant transformation or enlargement of nodules in non-ablated areas. Mechanically, as demonstrated in an associated mouse lung tumor model, RFA not only effectively remove treated tumors but also stimulate antitumor immunity, which could inhibit tumor growth in non-ablated areas. MLT enhanced RFA-stimulated NK activity and exerted synergistic antitumor effects with RFA. Transcriptomics and proteomics analyses of residual tumor tissues revealed enhanced oxidative phosphorylation and reduced acidification as well as hypoxia in the tumor microenvironment, which suggests reprogrammed tumor metabolism after combined treatment with RFA and MLT. Analysis of residual tumor further revealed the depressed activity of MAPK, NF-kappa B, Wnt, and Hedgehog pathways and upregulated P53 pathway in tumors, which was in line with the inhibited tumor growth. Combined RFA and MLT treatment also reversed the Warburg effect and decreased tumor malignancy. These findings thus demonstrated that combined treatment of RFA and MLT effectively inhibited the malignancy of non-ablated nodules and provided an innovative non-invasive strategy for treating early lung tumors with multiple pulmonary nodules. Trial registration: www.chictr.org.cn, identifier ChiCTR2100042695, http://www.chictr.org.cn/showproj.aspx?proj=120931.
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Affiliation(s)
- Ming Li
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bingjie Hao
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Menghuan Zhang
- State Key Laboratory of Molecular Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China
| | - Russel J Reiter
- Department of Cell Systems and Anatomy, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Shumeng Lin
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tiansheng Zheng
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiangyun Chen
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yanbei Ren
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liduo Yue
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Baigenzhin Abay
- National Scientific Medical Research Center, Astana, Kazakhstan
| | - Guojie Chen
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao Xu
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yufeng Shi
- Tongji University Cancer Center, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, China. .,Clinical Center For Brain And Spinal Cord Research, Tongji University, Shanghai, China.
| | - Lihong Fan
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China. .,Institute of Energy Metabolism and Health, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
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26
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Ahrar K, Tam AL, Kuban JD, Wu CC. Imaging of the thorax after percutaneous thermal ablation of lung malignancies. Clin Radiol 2021; 77:31-43. [PMID: 34384562 DOI: 10.1016/j.crad.2021.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/22/2021] [Indexed: 01/25/2023]
Abstract
Image-guided thermal ablation is a minimally invasive treatment option for patients with early stage non-small cell lung cancer or metastatic disease to the lungs. Percutaneous ablation treats malignant tumours in situ, which precludes histopathological evaluation of the ablated tumours. Imaging studies are used as surrogates to assess technical and clinical success. Although it is not universally accepted, a common protocol for surveillance imaging includes contrast-enhanced computed tomography (CT) at 1, 3, 6, 9, 12, 18, 24 months, and yearly thereafter. Integrated 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography (PET)/CT imaging is recommended at 3 and 12 months and when recurrent disease is suspected. There is a complex evolution of the ablation zone on CT and PET imaging studies. The zone of ablation, initially larger than the ablated tumour, undergoes gradual involution. In the process, it may cavitate and resemble a lung abscess. Different contrast-enhancement and radionuclide uptake patterns in and around the ablation zone may indicate a wide range of diagnostic possibilities from a normal physiological response to local progression. Ultimately, the zone of ablation may be replaced by a variety of findings including linear bands of density, pleural thickening, or residual necrotic tumour. Diagnostic and interventional radiologists interpreting post-ablation imaging studies must have a clear understanding of the ablation process and imaging findings on surveillance studies. Accurate and timely recognition of complications and/or local recurrence is necessary to guide further therapy. The purpose of this article is to review imaging protocols and salient imaging findings after thermal ablation of lung malignancies.
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Affiliation(s)
- K Ahrar
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Centre, Houston, TX 77030, USA.
| | - A L Tam
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Centre, Houston, TX 77030, USA
| | - J D Kuban
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Centre, Houston, TX 77030, USA
| | - C C Wu
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Centre, Houston, TX 77030, USA
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Genshaft SJ, Suh RD, Abtin F, Baerlocher MO, Chang AJ, Dariushnia SR, Devane AM, Faintuch S, Himes EA, Lisberg A, Padia S, Patel S, Tam AL, Yanagawa J. Society of Interventional Radiology Multidisciplinary Position Statement on Percutaneous Ablation of Non-small Cell Lung Cancer and Metastatic Disease to the Lungs: Endorsed by the Canadian Association for Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology. J Vasc Interv Radiol 2021; 32:1241.e1-1241.e12. [PMID: 34332724 DOI: 10.1016/j.jvir.2021.04.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To state the Society of Interventional Radiology's position on the use of image-guided thermal ablation for the treatment of early stage non-small cell lung cancer, recurrent lung cancer, and metastatic disease to the lung. MATERIALS AND METHODS A multidisciplinary writing group, with expertise in treating lung cancer, conducted a comprehensive literature search to identify studies on the topic of interest. Recommendations were drafted and graded according to the updated SIR evidence grading system. A modified Delphi technique was used to achieve consensus agreement on the recommendation statements. RESULTS A total of 63 studies, including existing systematic reviews and meta-analysis, retrospective cohort studies, and single-arm trials were identified. The expert writing group developed and agreed on 7 recommendations on the use of image-guided thermal ablation in the lung. CONCLUSION SIR considers image-guided thermal ablation to be an acceptable treatment option for patients with inoperable Stage I NSCLC, those with recurrent NSCLC, as well as patients with metastatic lung disease.
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Affiliation(s)
- Scott J Genshaft
- Department of Radiologic Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA.
| | - Robert D Suh
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Fereidoun Abtin
- Department of Radiology, Thoracic and Interventional Section, David Geffen School of Medicine, University of California, Los Angeles, CA
| | | | - Albert J Chang
- Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Sean R Dariushnia
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Atlanta, GA
| | - A Michael Devane
- Department of Radiology, Prisma Health, University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Salomao Faintuch
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Aaron Lisberg
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Siddharth Padia
- Department of Radiology, Section of Interventional Radiology, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Sheena Patel
- Society of Interventional Radiology, Fairfax, VA
| | - Alda L Tam
- Department of Interventional Radiology, MD Anderson Cancer Center, Houston, TX
| | - Jane Yanagawa
- Division of Thoracic Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
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28
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Grasso RF, Andresciani F, Altomare C, Pacella G, Castiello G, Carassiti M, Quattrocchi CC, Faiella E, Beomonte Zobel B. Lung Thermal Ablation: Comparison between an Augmented Reality Computed Tomography (CT) 3D Navigation System (SIRIO) and Standard CT-Guided Technique. BIOLOGY 2021; 10:biology10070646. [PMID: 34356501 PMCID: PMC8301158 DOI: 10.3390/biology10070646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/25/2021] [Accepted: 07/08/2021] [Indexed: 12/25/2022]
Abstract
Simple Summary Lung cancer is the leading cause of cancer mortality worldwide. In recent years, numerous technologies have been used to perform image-guided percutaneous thermal ablation, mainly including radiofrequency ablation, microwave ablation, and cryoablation. These image-guided ablation techniques have emerged as a safe, cost-effective, minimally invasive treatment alternative for patients who do not require surgery. Procedural planning, monitoring, and lesion targeting are generally performed with the help of computed tomography; navigation systems are emerging as valid tool to reduce procedural time and radiation dose administration. In the present paper, we investigate the efficacy of an optical-based navigation system (SIRIO) to perform lung thermal ablation. SIRIO proved to be a reliable and effective tool when performing CT-guided LTA, displaying a significant decrease in the number of required CT scans, procedure time, and radiation doses administered to patients. Abstract (1) Background: The aim of this retrospective study is to assess safety and efficacy of lung radiofrequency (RFA) and microwave ablation (MWA) using an augmented reality computed tomography (CT) navigation system (SIRIO) and to compare it with the standard CT-guided technique. (2) Methods: Lung RFA and MWA were performed with an augmented reality CT 3D navigation system (SIRIO) in 52 patients. A comparison was then performed with a group of 49 patients undergoing the standard CT-guided technique. All the procedures were divided into four groups based on the lesion diameter (>2 cm or ≤2 cm), and procedural time, the number of CT scans, radiation dose administered, and complications rate were evaluated. Technical success was defined as the presence of a “ground glass” area completely covering the target lesion at the immediate post-procedural CT. (3) Results: Full technical success was achieved in all treated malignant lesions for all the considered groups. SIRIO-guided lung thermo-ablations (LTA) displayed a significant decrease in the number of CT scans, procedure time, and patients’ radiation exposure (p < 0.001). This also resulted in a dosage reduction in hypnotics and opioids administrated for sedation during LTA. No significant differences were observed between the SIRIO and non-SIRIO group in terms of complications incidence. (4) Conclusions: SIRIO is an efficient tool to perform CT-guided LTA, displaying a significant reduction (p < 0.001) in the number of required CT scans, procedure time, and patients’ radiation exposure.
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Affiliation(s)
- Rosario Francesco Grasso
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
- Correspondence:
| | - Flavio Andresciani
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
| | - Carlo Altomare
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
| | - Giuseppina Pacella
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
| | - Gennaro Castiello
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
| | - Massimiliano Carassiti
- Unit of Anesthesia, Intensive Care and Pain Management, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy;
| | - Carlo Cosimo Quattrocchi
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
| | - Eliodoro Faiella
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
| | - Bruno Beomonte Zobel
- Department of Diagnostic and Interventional Radiology, University Hospital Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.A.); (C.A.); (G.P.); (G.C.); (C.C.Q.); (E.F.); (B.B.Z.)
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Peng J, Bie Z, Li Y, Li B, Guo R, Wang C, Li X. Microwave ablation of lung malignancies with coexisting severe emphysema: a retrospective analysis of safety and efficacy in 26 patients. Int J Hyperthermia 2021; 38:136-143. [PMID: 33541162 DOI: 10.1080/02656736.2021.1876254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
PURPOSE This retrospective study aimed to evaluate the safety and efficacy of microwave ablation (MWA) for lung malignancies in patients with severe emphysema. MATERIALS AND METHODS The clinical records of 1075 consecutive patients treated for malignant lung tumors in our department were retrospectively reviewed. Emphysema was assessed based on standard-dose computed tomography (CT) and was considered severe when it occupied ≥25% of the lung. Overall, 26 patients (24 men and 2 women; mean age ± standard deviation [SD]: 71.23 ± 8.18 years, range: 59-88 years) with severe emphysema underwent CT-guided percutaneous MWA for treating 26 tumors (24: non-small cell lung cancer and 2: metastases). The mean tumor size was 3.0 cm (SD: 1.5, range: 1.2-6.5 cm). Follow-up was performed with CT at 1, 3, 6, 12 months after ablation, and every 6 months thereafter. Complications and efficacy were evaluated. RESULTS The median follow-up duration in all patients was 17.5 months (range: 5-37 months, interquartile range: 15.8). The mortality rate was 0% within 30 days after ablation. Major complications including pneumonia, lung abscess and refractory pneumothorax occurred in 19.2% (5/26) patients. The technical success and efficacy rates were 88.5% (23/26) and 87.0% (20/23), respectively, and the local tumor progression rate was 30.0% (6/20). CONCLUSION MWA appears to be a safe and effective therapeutic option for treating lung malignancies in patients with severe emphysema.
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Affiliation(s)
- Jinzhao Peng
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhixin Bie
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuanming Li
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Li
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Runqi Guo
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chengen Wang
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoguang Li
- Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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30
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Habert P, Di Bisceglie M, Bartoli A, Jacquier A, Brige P, Vidal V, Hak JF, Tradi F, Gaubert JY. Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT. Int J Hyperthermia 2021; 38:786-794. [PMID: 34032532 DOI: 10.1080/02656736.2021.1928773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for pulmonary tumors. Patterns on chest computed tomography (CT) after RFA are classified into five types; however, the follow-up has not been fully described. The objectives of this study were to describe (1) the CT pattern 3 years after RFA and (2) its evolution over 7 years. MATERIALS AND METHODS Lesions treated with RFA between 2009 and 2017 and with ≥3 years of follow-up CT data were included. Lesions with local recurrences were excluded from the study. The morphology of the ablation zone was classified as nodular, fibrotic, atelectatic, cavitary, and disappeared. Other initial anatomical parameters were recorded. Kruskal-Wallis or Chi-square tests were used to compare the groups. RESULTS One hundred lung RFA scars were included, and a retrospective longitudinal study was performed. Three years after RFA, nodular, fibrotic, atelectatic, and cavitary scars, and disappearance were observed in 49%, 36%, 5%, 3%, and 6% of the scars, respectively. Evolution over 7 years showed that the fibrosis, atelectasis, and disappearance remained stable over time, whereas 28% of nodular scars evolved into fibrotic scars. Additionally, 45% of cavitary scars evolved into nodular scars. Pleural contact was associated with disappearance, and the use of a 20-mm needle was associated with atelectasis. CONCLUSION Follow-up after RFA showed that fibrosis, disappearance, and atelectasis remained stable over time. Nodular scars could evolve into fibrotic scars, and cavitary scars could evolve into nodular scars.
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Affiliation(s)
- Paul Habert
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Mathieu Di Bisceglie
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Axel Bartoli
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,Centre d'exploration métabolique par résonnance magnétique CEMEREM, Aix-Marseille Université, Marseille, France
| | - Alexis Jacquier
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,Centre d'exploration métabolique par résonnance magnétique CEMEREM, Aix-Marseille Université, Marseille, France
| | - Pauline Brige
- LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Vincent Vidal
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Jean-François Hak
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Farouk Tradi
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Jean-Yves Gaubert
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
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31
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Xu F, Song J, Lu Y, Wang J, Wang J, Xiao H, Li Z. Clinical efficacy of systemic chemotherapy combined with radiofrequency ablation and microwave ablation for lung cancer: a comparative study. Int J Hyperthermia 2021; 38:900-906. [PMID: 34148500 DOI: 10.1080/02656736.2021.1936214] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Local thermal ablation, a minimally invasive technique, has been widely used in clinical treatment of lung cancer. This study aimed to discuss the clinical efficacy of systemic chemotherapy combined with radiofrequency ablation (RFA) versus systemic chemotherapy combined with microwave ablation (MWA) in treating lung cancer. METHODS A retrospective analysis involving 124 lung cancer patients, who received RFA (n = 68) and MWA (n = 56) combined with systemic chemotherapy in Cangzhou People's Hospital from August 2017 to December 2019, was conducted. Before comparative analysis for therapeutic efficacy, the two groups of patients were matched with propensity score matching method at a ratio of 1:1. Indicators including progression-free survival (PFS), overall survival (OS), short-term efficacy, tumor marker level, local tumor control rate, and postoperative complications were comparatively analyzed. RESULTS There was no statistical difference in disease control rate and objective response rate (90.6% and 78.1% vs 93.8% and 84.4%) between RFA group and MWA group. The incidence of complications was 12.5% in RFA group and 18.8% in MWA group with no statistically significant difference. In addition, the local tumor control rate in MWA group (90.6%) was significantly higher than that in RFA group (78.1%). Regarding survival, a statistically significant difference was observed in median PFS of RFA and MWA groups (9.2 months vs 10.4 months, p < 0.05), while OS in two groups slightly varied. CONCLUSION MWA was superior to RFA over local tumor control rate and PFS and showed great potential in lung cancer ablation treatment.
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Affiliation(s)
- Feng Xu
- Department of Pulmonary and Critical Care Medicine, Cangzhou People's Hospital, Cangzhou, China
| | - Jian Song
- Department of Pulmonary and Critical Care Medicine, Cangzhou People's Hospital, Cangzhou, China
| | | | - Jiang Wang
- Department of Pulmonary and Critical Care Medicine, Cangzhou People's Hospital, Cangzhou, China
| | - Jing Wang
- Department of Pulmonary and Critical Care Medicine, Cangzhou People's Hospital, Cangzhou, China
| | - Haiyan Xiao
- Department of Pulmonary and Critical Care Medicine, Cangzhou People's Hospital, Cangzhou, China
| | - Zhenzhen Li
- Department of Pulmonary and Critical Care Medicine, Cangzhou People's Hospital, Cangzhou, China
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Yan P, Tong AN, Nie XL, Ma MG. Assessment of safety margin after microwave ablation of stage I NSCLC with three-dimensional reconstruction technique using CT imaging. BMC Med Imaging 2021; 21:96. [PMID: 34098894 PMCID: PMC8185913 DOI: 10.1186/s12880-021-00626-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/27/2021] [Indexed: 12/24/2022] Open
Abstract
Objective To assess the ablative margin of microwave ablation (MWA) for stage I non-small cell lung cancer (NSCLC) using a three-dimensional (3D) reconstruction technique. Materials and methods We retrospectively analyzed 36 patients with stage I NSCLC lesions undergoing MWA and analyzed the relationship between minimal ablative margin and the local tumor progression (LTP) interval, the distant metastasis interval and disease-free survival (DFS). The minimal ablative margin was measured using the fusion of 3D computed tomography reconstruction technique. Results Univariate and multivariate analyses indicated that tumor size (hazard ratio [HR] = 1.91, P < 0.01; HR = 2.41, P = 0.01) and minimal ablative margin (HR = 0.13, P < 0.01; HR = 0.11, P < 0.01) were independent prognostic factors for the LTP interval. Tumor size (HR = 1.96, P < 0.01; HR = 2.35, P < 0.01) and minimal ablative margin (HR = 0.17, P < 0.01; HR = 0.13, P < 0.01) were independent prognostic factors for DFS by univariate and multivariate analyses. In the group with a minimal ablative margin < 5 mm, the 1-year and 2-year local progression-free rates were 35.7% and 15.9%, respectively. The 1-year and 2-year distant metastasis-free rates were 75.6% and 75.6%, respectively; the 1-year and 2-year disease-free survival rates were 16.7% and 11.1%, respectively. In the group with a minimal ablative margin ≥ 5 mm, the 1-year and 2-year local progression-free rates were 88.9% and 69.4%, respectively. The 1-year and 2-year distant metastasis-free rates were 94.4% and 86.6%, respectively; the 1-year and 2-year disease-free survival rates were 88.9% and 63.7%, respectively. The feasibility of 3D quantitative analysis of the ablative margins after MWA for NSCLC has been validated. Conclusions The minimal ablative margin is an independent factor of NSCLC relapse after MWA, and the fusion of 3D reconstruction technique can feasibly assess the minimal ablative margin. Supplementary Information The online version contains supplementary material available at 10.1186/s12880-021-00626-z.
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Affiliation(s)
- Peng Yan
- Department of Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - An-Na Tong
- Department of Radiation, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, People's Republic of China
| | - Xiu-Li Nie
- Department of Radiology, Jinan Central Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Min-Ge Ma
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
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Palussière J, Cazayus M, Cousin S, Cabart M, Chomy F, Catena V, Buy X. Is There a Role for Percutaneous Ablation for Early Stage Lung Cancer? What Is the Evidence? Curr Oncol Rep 2021; 23:81. [PMID: 33948744 DOI: 10.1007/s11912-021-01072-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW For patients with early stage non-small-cell lung cancer (NSCLC), thermal ablation (TA) has become in the least two decades an option of treatment used worldwide for patients with comorbidities who are not surgical candidates. Here, we review data published with different TA techniques: radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation. This paper reviews also the comparison that has been made between TA and stereotactic radiotherapy (SBRT). RECENT FINDINGS A majority of retrospective studies, the absence of comparative studies, and the variety of techniques make difficult to get evident data. Nevertheless, these stand-alone techniques have demonstrated local efficacy for tumors less than 3 cm and good tolerance on fragile patients. Many recent reviews and database analyses show that outcomes after TA (mainly RFA and MWA) are comparable to SBRT in terms of survival rates. For patients who are unfit for surgery, TA has demonstrated interesting results for safety, benefits in overall survival, and acceptable local control.
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Affiliation(s)
- J Palussière
- Imaging Department, Institut Bergonié, 229 cours de l'Argonne, 33076, Bordeaux, France.
| | - M Cazayus
- Imaging Department, Institut Bergonié, 229 cours de l'Argonne, 33076, Bordeaux, France
| | - S Cousin
- Oncology Department, Institut Bergonié, Bordeaux, France
| | - M Cabart
- Oncology Department, Institut Bergonié, Bordeaux, France
| | - F Chomy
- Oncology Department, Institut Bergonié, Bordeaux, France
| | - V Catena
- Imaging Department, Institut Bergonié, 229 cours de l'Argonne, 33076, Bordeaux, France
| | - X Buy
- Imaging Department, Institut Bergonié, 229 cours de l'Argonne, 33076, Bordeaux, France
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Páez-Carpio A, Gómez FM, Isus Olivé G, Paredes P, Baetens T, Carrero E, Sánchez M, Vollmer I. Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art. Insights Imaging 2021; 12:57. [PMID: 33914187 PMCID: PMC8085189 DOI: 10.1186/s13244-021-00997-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/09/2021] [Indexed: 12/25/2022] Open
Abstract
Image-guided percutaneous lung ablation has proven to be a valid treatment alternative in patients with early-stage non-small cell lung carcinoma or oligometastatic lung disease. Available ablative modalities include radiofrequency ablation, microwave ablation, and cryoablation. Currently, there are no sufficiently representative studies to determine significant differences between the results of these techniques. However, a common feature among them is their excellent tolerance with very few complications. For optimal treatment, radiologists must carefully select the patients to be treated, perform a refined ablative technique, and have a detailed knowledge of the radiological features following lung ablation. Although no randomized studies comparing image-guided percutaneous lung ablation with surgery or stereotactic radiation therapy are available, the current literature demonstrates equivalent survival rates. This review will discuss image-guided percutaneous lung ablation features, including available modalities, approved indications, possible complications, published results, and future applications.
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Affiliation(s)
- Alfredo Páez-Carpio
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain.
| | - Fernando M Gómez
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gemma Isus Olivé
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Pilar Paredes
- Department of Nuclear Medicine, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Tarik Baetens
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Enrique Carrero
- Department of Anesthesiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ivan Vollmer
- Department of Radiology, CDI, Hospital Clínic, University of Barcelona, Barcelona, Spain
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35
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Li M, Xu X, Qin Y, Zhang P, Shen C, Xia Q, Fan L. Radiofrequency ablation vs. stereotactic body radiotherapy for stage IA non-small cell lung cancer in nonsurgical patients. J Cancer 2021; 12:3057-3066. [PMID: 33854605 PMCID: PMC8040894 DOI: 10.7150/jca.51413] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 12/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Approximately 20% resectable non-small cell lung cancer (NSCLC) patients are treated non-surgically due to various reasons. The aim of the present study was to compare the effectiveness of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) in patients with stage IA NSCLC who were ineligible for surgery using the surveillance, epidemiology and end-results (SEER) Database. Methods: Using the SEER registry, we identified a total of 6,195 IA NSCLC patients who received SBRT or RFA between 2004 and 2015 because of ineligibility for surgical resection due to various reasons. Complete clinical information was available in all these patients. Overall survival (OS) and cancer-specific survival (CSS) were compared between RFA and SBRT groups by using propensity score matching (PSM), inverse probability of treatment weight (IPTW), and overlap weighting analysis. Additionally, an exploratory analysis was conducted to determine the effectiveness of RFA treatment based on the subsets of clinically relevant patients. Results: Of the 6,195 nonsurgical IA NSCLC patients, 191 patients (3.1%) received RFA and the other 6,004 patients (96.9%) received SBRT. The one-, three- and five-year OS in the unmatched RFA and SBRT groups were 83.3%, 48.5%and 29.1% vs. 83.8%, 48.3% and 27.4%, respectively, there was similar results in the PSM, IPTW, overlap weighing analysis. Nonsurgical IA NSCLC patients receiving RFA seemed to have better five-year survival than those receiving SBRT, though the difference was not statistically significant (OS, HR; 0.986; 95% CI, 0.827-1.175, P=0.8738; CSS, HR; 0.965; 95% CI, 0.765-1.219, P=0.7663). We found that the odds of receiving RFA decreased with larger tumor size (>2, <3 cm, OR; 0.303; 95% CI, 0.191-0.479; >3 cm, OR; 0.153; 95% CI, 0.093-0.251) compared with tumor size <1 cm. In subgroup analysis, patients receiving RFA seemed to have better OS than those receiving SBRT, though the difference was not statistically significant. This specific trend was even more obvious in patients with tumors <1cm in diameter (P=0.1577). Conclusion: In comparison with SBRT, RFA did not seem to adversely affect CSS and OS of IA NSCLC patients who were not suitable for surgical treatment. In addition, RFA seemed to offer better survival to IA NSCLC patients, especially those with tumors <1 cm.
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Affiliation(s)
- Ming Li
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Xiao Xu
- Shanghai Clinical College, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Yingyi Qin
- Department of Health Statistics, Second Military Medical University, Shanghai 200433, China
| | - Peng Zhang
- Department of Cardio-Thoracic Surgery, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Changxing Shen
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Qing Xia
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Lihong Fan
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Clinical College, Anhui Medical University, Hefei 230032, Anhui Province, China
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Quirk MT, Lee S, Murali N, Genshaft S, Abtin F, Suh R. Alternatives to Surgery for Early-Stage Non-Small Cell Lung Cancer: Thermal Ablation. Clin Chest Med 2020; 41:197-210. [PMID: 32402356 DOI: 10.1016/j.ccm.2020.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Thermal ablation involves the application of heat or cold energy to the lung under image guidance to eradicate tumors. It is indicated for treatment of early-stage non-small cell lung cancer in nonsurgical patients. Ablation technologies have advanced, such that nearly all small tumors can now be treated safely and effectively. Ablation does not cause a lasting decline in pulmonary function tests and may therefore be used to treat multiple synchronous and metachronous lung tumors, a chief advantage over other treatments. Large series with intermediate- and long-term data have been reported showing favorable overall survival, similar to radiation therapy.
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Affiliation(s)
- Matthew T Quirk
- Department of Radiology, UCLA Health, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095, USA.
| | - Shimwoo Lee
- Department of Radiology, UCLA Health, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095, USA
| | - Nikitha Murali
- Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
| | - Scott Genshaft
- Department of Radiology, UCLA Health, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095, USA
| | - Fereidoun Abtin
- Department of Radiology, UCLA Health, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095, USA
| | - Robert Suh
- Department of Radiology, UCLA Health, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095, USA
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37
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Thakore S, Perez Lozada JC. Percutaneous Ablation of Intrathoracic Malignancy. CURRENT PULMONOLOGY REPORTS 2020. [DOI: 10.1007/s13665-020-00262-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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Bakhribah H, Zeitouni M, Daghistani RA, Almaghraby HQ, Khankan AA, Alkattan KM, Alshehri SM, Jazieh AR. Implications of COVID-19 pandemic on lung cancer management: A multidisciplinary perspective. Crit Rev Oncol Hematol 2020; 156:103120. [PMID: 33099232 PMCID: PMC7546967 DOI: 10.1016/j.critrevonc.2020.103120] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/27/2020] [Accepted: 09/27/2020] [Indexed: 02/07/2023] Open
Abstract
Treatment of patients with lung cancer during the current COVID-19 pandemic is challenging. Lung cancer is a heterogenous disease with a wide variety of therapeutic options. Oncologists have to determine the risks and benefits of modifying the treatment plans of patients especially in situation where the disease biology and treatment are complex. Health care visits carry a risk of transmission of SARS-CoV-2 and the similarities of COVID-19 symptoms and lung cancer manifestations represent a dominant problem. Efforts to modify treatment of lung cancer during the current pandemic have been adapted by many healthcare institutes to reduce exposure of lung cancer patients to SARS-CoV-2. We summarized the implications of COVID-19 pandemic on the management of lung cancer from the perspective of different specialties of thoracic oncology multidisciplinary team.
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Affiliation(s)
- Hatoon Bakhribah
- Oncology Center, King Fahad Medical City, Riyadh, KSA, Saudi Arabia
| | - Mohammad Zeitouni
- Pulmonary Division, King Faisal Specialist Hospital and Research Center, Riyadh, KSA, Saudi Arabia
| | | | - Hatim Q Almaghraby
- Dept. of Pathology and Laboratory Medicine, King Abdulaziz Medical City and King Saud University for Health Sciences, MNGHA, Jeddah, KSA, Saudi Arabia
| | - Azzam A Khankan
- Interventional Radiology, Imaging Department, King Abdulaziz Medical City, Jeddah, KSA, Saudi Arabia
| | | | - Salem M Alshehri
- Oncology Department, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, KSA, Saudi Arabia
| | - Abdul Rahman Jazieh
- Oncology Department, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, KSA, Saudi Arabia.
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39
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Gou Q, Zhou Z, Zhao M, Chen X, Zhou Q. [Advances and Challenges of Local Thermal Ablation in Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 23:111-117. [PMID: 32093455 PMCID: PMC7049787 DOI: 10.3779/j.issn.1009-3419.2020.02.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
非小细胞肺癌(non-small cell lung cancer, NSCLC)是原发性肺癌的主要类型,手术切除、放化疗、靶向治疗及免疫治疗等是其主要的治疗模式。近年来,热消融在各期NSCLC的临床应用中受到越来越多的关注。热消融作为一种安全、高效的局部治疗手段,合理的临床应用可以给NSCLC患者带来更多的临床获益。然而其在NSCLC中的应用仍然存在许多尚待研究探讨的问题。本文对近年来热消融在NSCLC中的应用现状作以综述,旨在探讨目前存在的争议问题和未来研究方向。
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Affiliation(s)
- Qing Gou
- Department of Interventional Oncology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China
| | - Zejian Zhou
- Department of Interventional Oncology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China
| | - Mingfang Zhao
- The First Hospital of China Medical University, Department of Medical Oncology, Shenyang 110001, China
| | - Xiaoming Chen
- Department of Interventional Oncology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China
| | - Qing Zhou
- Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Lung Cancer Institute, Guangzhou 510080, China
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40
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Halsey K, Wu J, Su C, Hsieh B, Yi T, Collins SA, Kimia B, Zhang PJ, Healey T, Zhang Z, Bai HX. Ablation Therapy for Advanced Stage Non-Small Cell Lung Cancer: A National Cancer Database Study. J Vasc Interv Radiol 2020; 31:1210-1215.e4. [PMID: 32460964 DOI: 10.1016/j.jvir.2020.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/22/2020] [Accepted: 02/16/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To compare overall survival (OS) of ablation with no treatment for patients with advanced stage non-small cell lung cancer. METHODS Patients with clinical stage IIIB (T1-4N3M0, T4N2M0) and stage IV (T1-4N0-3M1) non-small cell lung cancer, in accordance with the American Joint Committee on Cancer, 7th edition, who did not receive treatment or who received ablation as their sole primary treatment besides chemotherapy from 2004 to 2014, were identified from the National Cancer Data Base. OS was estimated using the Kaplan-Meier method and evaluated by log-rank test, univariate and multivariate Cox proportional hazard regression, and propensity score-matched analysis. Relative survival analyses comparing age- and sex-matched United States populations were performed. RESULTS A total of 140,819 patients were included. The 1-, 2-, 3- and 5-year survival rates relative to age- and sex-matched United States population were 28%, 18%, 12%, and 10%, respectively, for ablation (n = 249); and 30%, 15%, 9%, and 5%, respectively for no treatment (n = 140,570). Propensity score matching resulted in 249 patients in the ablation group versus 498 patients in the no-treatment group. After matching, ablation was associated with longer OS than that in the no-treatment group (median, 5.9 vs 4.7 months, respectively; hazard ratio, 0.844; 95% confidence interval, 0.719-0.990; P = .037). These results persisted in patients with an initial tumor size of ≤3 cm. CONCLUSIONS Preliminary results suggest ablation may be associated with longer OS in patients with late-stage non-small cell lung cancer than survival in those who received no treatment.
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Affiliation(s)
- Kasey Halsey
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jing Wu
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chang Su
- Yale School of Medicine, New Haven, Connecticut
| | - Ben Hsieh
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island
| | - Thomas Yi
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Scott A Collins
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island
| | - Benjamin Kimia
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island
| | - Paul J Zhang
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Terrance Healey
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island
| | - Zishu Zhang
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Harrison X Bai
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island.
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41
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Venturini M, Cariati M, Marra P, Masala S, Pereira PL, Carrafiello G. CIRSE Standards of Practice on Thermal Ablation of Primary and Secondary Lung Tumours. Cardiovasc Intervent Radiol 2020; 43:667-683. [PMID: 32095842 DOI: 10.1007/s00270-020-02432-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 02/10/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Massimo Venturini
- Department of Diagnostic and Interventional Radiology, Circolo Hospital, Insubria University, Varese, Italy.
| | - Maurizio Cariati
- Department of Diagnostic and Interventional Radiology, ASST Santi Carlo e Paolo Hospital, Milan, Italy
| | - Paolo Marra
- Department of Radiology, Papa Giovanni XXIII Hospital Bergamo, Milano-Bicocca University, Milan, Italy
| | - Salvatore Masala
- Department of Radiology, San Giovanni Battista Hospital, Tor Vergata University, Rome, Italy
| | - Philippe L Pereira
- Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK-Kliniken GmbH, Heilbronn, Germany
| | - Gianpaolo Carrafiello
- Department of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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42
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Matsui Y, Iguchi T, Tomita K, Uka M, Sakurai J, Gobara H, Kanazawa S. Radiofrequency Ablation for Stage I Non-Small Cell Lung Cancer: An Updated Review of Literature from the Last Decade. INTERVENTIONAL RADIOLOGY 2020; 5:43-49. [PMID: 36284655 PMCID: PMC9550390 DOI: 10.22575/interventionalradiology.2020-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/10/2020] [Indexed: 11/30/2022]
Abstract
This review summarizes the current findings on radiofrequency ablation (RFA) for stage I non-small cell lung cancer (NSCLC) from relevant literature published in the last decade. While most earlier studies included small populations and had short follow-up periods, more robust data have become available owing to prospective or large cohort studies. The reported overall survival rates after RFA for stage I NSCLC were 83-96%, 40-74%, and 23-61% at 1, 3, and 5 years, respectively, in recent studies. Furthermore, many comparative studies on the outcomes of RFA and stereotactic body radiotherapy have been performed. Most of these studies report no significant difference in survival outcomes between the therapies. Currently, major guidelines define RFA as a reasonable alternative treatment for stage I NSCLC in non-surgical candidates.
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Affiliation(s)
- Yusuke Matsui
- Department of Radiology, Okayama University Medical School
| | | | - Koji Tomita
- Department of Radiology, Okayama University Medical School
| | - Mayu Uka
- Department of Radiology, Okayama University Medical School
| | - Jun Sakurai
- Center for Innovative Clinical Medicine, Okayama University Hospital
| | - Hideo Gobara
- Department of Medical Informatics, Okayama University Hospital
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43
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Eiken PW, Welch BT. Cryoablation of Lung Metastases: Review of Recent Literature and Ablation Technique. Semin Intervent Radiol 2019; 36:319-325. [PMID: 31680723 DOI: 10.1055/s-0039-1697002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This article reviews the current indications for image-guided thermal ablation of pulmonary metastatic disease. It also summarizes data regarding the efficacy and complications of lung cryoablation and present techniques for performing lung cryoablation as informed by the recent literature.
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Affiliation(s)
| | - Brian T Welch
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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44
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Bronchoscopic Ablative Therapies for Malignant Central Airway Obstruction and Peripheral Lung Tumors. Ann Am Thorac Soc 2019; 16:1220-1229. [DOI: 10.1513/annalsats.201812-892cme] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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45
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Auloge P, Cazzato RL, Koch G, Caudrelier J, De Marini P, Garnon J, Gangi A. Destruction tumorale percutanée. Presse Med 2019; 48:1146-1155. [DOI: 10.1016/j.lpm.2019.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/02/2019] [Indexed: 02/06/2023] Open
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46
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Palussière J, Catena V, Lagarde P, Cousin S, Cabart M, Buy X, Chomy F. Primary tumors of the lung: should we consider thermal ablation as a valid therapeutic option? Int J Hyperthermia 2019; 36:46-52. [DOI: 10.1080/02656736.2019.1647351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
| | | | | | - Sophie Cousin
- Oncology Department, Institut Bergonié, Bordeaux, France
| | | | - Xavier Buy
- Imaging Department, Institut Bergonié, Bordeaux, France
| | - François Chomy
- Oncology Department, Institut Bergonié, Bordeaux, France
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47
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48
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Tafti BA, Genshaft S, Suh R, Abtin F. Lung Ablation: Indications and Techniques. Semin Intervent Radiol 2019; 36:163-175. [PMID: 31435124 DOI: 10.1055/s-0039-1693981] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Lung ablation is ever more recognized since its initial report and use almost two decades ago. With technological advancements in thermal modalities, particularly microwave ablation and cryoablation, better identification of the cohort of patients who best benefit from ablation, and understanding the role of imaging after ablation, image-guided thermal ablation for primary and secondary pulmonary malignancies is increasingly recognized and accepted as a cogent form of local therapy.
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Affiliation(s)
- Bashir Akhavan Tafti
- Divisions of Interventional Radiology, David Geffen School of Medicine, UCLA Health System, Los Angeles, California
| | - Scott Genshaft
- Thoracic Imaging at the Department of Radiological Sciences, David Geffen School of Medicine, UCLA Health System, Los Angeles, California
| | - Robert Suh
- Divisions of Interventional Radiology, David Geffen School of Medicine, UCLA Health System, Los Angeles, California.,Thoracic Imaging at the Department of Radiological Sciences, David Geffen School of Medicine, UCLA Health System, Los Angeles, California
| | - Fereidoun Abtin
- Divisions of Interventional Radiology, David Geffen School of Medicine, UCLA Health System, Los Angeles, California.,Thoracic Imaging at the Department of Radiological Sciences, David Geffen School of Medicine, UCLA Health System, Los Angeles, California
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49
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Osarogiagbon RU, Veronesi G, Fang W, Ekman S, Suda K, Aerts JG, Donington J. Early-Stage NSCLC: Advances in Thoracic Oncology 2018. J Thorac Oncol 2019; 14:968-978. [PMID: 30851441 PMCID: PMC6534444 DOI: 10.1016/j.jtho.2019.02.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/22/2019] [Accepted: 02/24/2019] [Indexed: 12/21/2022]
Abstract
2018 was a banner year for all thoracic oncology, but especially for early-stage NSCLC. Three seminal events occurred in the approximately 18 months from mid-2017 to the end of 2018: in June 2017 at the American Society of Clinical Oncology Annual Meeting a small, relatively unheralded study from Max Diehn's group at Stanford University reported on the use of a novel "cancer personalized profiling by deep sequencing" circulating tumor-DNA technology to identify minimal residual disease in patients after curative-intent radiation or surgery for NSCLC; in April 2018 at the American Association for Cancer Research Annual Meeting, Drew Pardoll presented a small pilot study of 21 patients who had received two doses of preoperative nivolumab; in September 2018, at the 19th World Conference on Lung Cancer, Harry J. De Koning presented the long-awaited results of the Dutch-Belgian Lung Cancer Screening Trial (NELSON). These three seminal studies, along with others which are reviewed in this paper, promise to accelerate our progress towards a world in which lung cancer is identified early, more patients undergo curative-intent treatment that achieves the promised cure, and those at risk for failure after treatment are identified early, when the cancer remains most vulnerable. The day is around the corner when lung cancer is defanged and no longer the worldwide terror it currently is. We herein present an overview of the most recent body of work that moves us inexorably towards that day.
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Affiliation(s)
| | - Giulia Veronesi
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Wentao Fang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Jiaotong University Medical School, Shanghai, China
| | - Simon Ekman
- Thoracic Oncology Center, Karolinska University Hospital/Dept of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Kenichi Suda
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Joachim G Aerts
- Thoracic Oncology Department, Erasumus University Medical Center, Rotterdam, Netherlands
| | - Jessica Donington
- Section of Thoracic Surgery, University of Chicago, Chicago, Illinois
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Lavaud P, Besse B, de Baere T, Deschamps F, Mussot S, Le Pechoux C, Caramella C, Mercier O, Mezquitta L, Botticella A, Pradere P, Adam J, Planchard D, Tselikas L. Focus on Recommendations for the Management of Non-small Cell Lung Cancer. Cardiovasc Intervent Radiol 2019; 42:1230-1239. [PMID: 31062067 DOI: 10.1007/s00270-019-02222-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 04/10/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Pernelle Lavaud
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Benjamin Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
- Faculté de médecine, Paris Sud, Paris Saclay, Orsay, France
| | - Thierry de Baere
- Faculté de médecine, Paris Sud, Paris Saclay, Orsay, France
- Interventional Radiology, Gustave Roussy, Villejuif, France
| | | | - Sacha Mussot
- Thoracic Surgery, Hopital Marie Lannelongue, Le Plessis Robinson, France
| | | | | | - Olaf Mercier
- Thoracic Surgery, Hopital Marie Lannelongue, Le Plessis Robinson, France
| | - Laura Mezquitta
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | | | - Pauline Pradere
- Pneumology, Hopital Marie Lannelongue, Le Plessis Robinson, France
| | - Julien Adam
- Pathology Department, Gustave Roussy, Villejuif, France
| | - David Planchard
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Lambros Tselikas
- Interventional Radiology, Gustave Roussy, Villejuif, France.
- Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif, France.
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