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Wu C, Cao B, He G, Li Y, Wang W. Stereotactic ablative brachytherapy versus percutaneous microwave ablation for early-stage non-small cell lung cancer: a multicenter retrospective study. BMC Cancer 2024; 24:304. [PMID: 38448897 PMCID: PMC10916219 DOI: 10.1186/s12885-024-12055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND To analyze the efficacy of stereotactic ablative brachytherapy (SABT) and percutaneous microwave ablation (MWA) for the treatment of early-stage non-small cell lung cancer (NSCLC). METHODS Patients with early-stage (T1-T2aN0M0) NSCLC who underwent CT-guided SABT or MWA between October 2014 and March 2017 at four medical centers were retrospectively analyzed. Survival, treatment response, and procedure-related complications were assessed. RESULTS A total of 83 patients were included in this study. The median follow-up time was 55.2 months (range 7.2-76.8 months). The 1-, 3-, and 5-year overall survival (OS) rates were 96.4%, 82.3%, and 68.4% for the SABT group (n = 28), and 96.4%, 79.7%, and 63.2% for MWA group (n = 55), respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 92.9%, 74.6%, and 54.1% for SABT, and 92.7%, 70.5%, and 50.5% for MWA, respectively. There were no significant differences between SABT and MWA in terms of OS (p = 0.631) or DFS (p = 0.836). The recurrence rate was also similar between the two groups (p = 0.809). No procedure-related deaths occurred. Pneumothorax was the most common adverse event in the two groups, with no significant difference. No radiation pneumonia was found in the SABT group. CONCLUSIONS SABT provided similar efficacy to MWA for the treatment of stage I NSCLC. SABT may be a treatment option for unresectable early-stage NSCLC. However, future prospective randomized studies are required to verify these results.
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Affiliation(s)
- Chuanwang Wu
- Department of Interventional Medicine,The Second Hospital of Shandong University, Institute of Tumor Intervention,Cheeloo college of medicine, Shandong University, Jinan City, Shandong Province, China
- Department of Fifth Internal Medicine, People's Hospital of Shizhong District, No.156 Jiefang Road, Zaozhuang City, Shandong Province, China
| | - Binglong Cao
- Department of Oncology, Qufu Hospital of Traditional Chinese Medicine, No.129 Canggeng Road, Qufu City, Shandong Province, China
| | - Guanghui He
- Department of Interventional Medicine, Weifang Second People's Hospital, Weifang city, Shandong Province, China
| | - Yuliang Li
- Department of Interventional Medicine,The Second Hospital of Shandong University, Institute of Tumor Intervention,Cheeloo college of medicine, Shandong University, Jinan City, Shandong Province, China
| | - Wujie Wang
- Department of Interventional Medicine,The Second Hospital of Shandong University, Institute of Tumor Intervention,Cheeloo college of medicine, Shandong University, Jinan City, Shandong Province, China.
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Buchalet C, Durdux C. Role of radiotherapy in the management of rare solid thoracic tumors of the adults. Cancer Radiother 2023; 27:614-621. [PMID: 37558606 DOI: 10.1016/j.canrad.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 08/11/2023]
Abstract
Thoracic tumors include more than one hundred histopathological subtypes. Rare thoracic malignancies can be defined as representing less than 1% of all thoracic tumors. The European Rare Cancer Surveillance Project (RARECARE) identified rarity as an incidence less than 6 for 100,000 people, with significant difference of prevalence between them. Modalities of treatment for these pathologies include surgery, radiotherapy, and systemic therapies. In this article, we aim to discuss role and techniques of radiotherapy in management of rare solid thoracic tumors in adults, focusing on different anatomical locations such as lung parenchyma, mediastinum, vessels, chest wall and pleural cavity.
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Affiliation(s)
- C Buchalet
- Département d'oncologie radiothérapie, Institut du Cancer de Montpellier, 208, avenue des Apothicaires, 34000 Montpellier, France.
| | - C Durdux
- Département d'oncologie radiothérapie, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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Huo B, Ji Z, He C, Yang W, Ma Y, Huo X, Wang Z, Zhao X, Dai J, Wang H, Chen G, Wang R, Song Y, Zhang K, Huang X, Chai S, Wang J. Safety and efficacy of stereotactic ablative brachytherapy as a salvage therapy for recurrent chest wall cancer: A retrospective, multicenter study. Front Oncol 2023; 12:957497. [PMID: 36824397 PMCID: PMC9942776 DOI: 10.3389/fonc.2022.957497] [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: 05/31/2022] [Accepted: 12/30/2022] [Indexed: 02/09/2023] Open
Abstract
Purpose To evaluate the safety and efficacy of stereotactic ablative brachytherapy (SABT) as a salvage therapy for patients with recurrent chest wall cancer (rCWC) who have previously received external beam radiotherapy (EBRT) or surgery. Materials and methods Between November 2013 and October 2020, a total of 130 patients (including 75 men with a median age of 63 years) with rCWC treated with SABT were enrolled in this multicenter retrospective study. There were 97 cases of non-small-cell lung carcinoma, 24 cases of breast cancer, and 9 cases of thymic cancer. Of the patients included, 102 patients previously received surgery and 58 patients received EBRT, with systemic treatment progressing after recurrence. None of them were suitable or refused to undergo salvage EBRT or surgery again. Results During the 22 (4-70)-month median patient follow-up, 59 patients died. The local control (LC) rates at 6, 12, 24, and 36 months were 88.3%, 74.3%, 50.4%, and 36.7%, respectively. The 1-, 2- and 3-year survival rates were 85%, 56%, and 42%, respectively. The median overall survival was 26 months (95% CI, 18.9-33.1 months). The pain relief rate was 81%, and the median to remission time was 10 days. Univariate and multivariate analyses showed that independent prognostic factors for LC included tumor size and postoperative D90. On the other hand, independent prognostic factors for survival include the Karnofsky performance status (KPS) score, tumor size, and D90 19 patients (14.6%) developed grade I/II skin reaction complications. No grade III or severer complications occurred. Conclusion SABT is safe and effective as a salvage therapy for rCWC following EBRT/surgery. For patients with a KPS score greater than 80, prescribed dose greater than 130 Gy, and tumor size less than 4 cm may bring better results.
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Affiliation(s)
- Bin Huo
- Department of Oncology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Chuang He
- Center of Minimally Invasive Intervention, Southwest Hospital of Army Medical University, Chongqing, China
| | - Wanying Yang
- Department of Oncology, Tengzhou Central People’s Hospital, Tengzhou, China
| | - Yanli Ma
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, China
| | - Xiaodong Huo
- Department of Oncology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhe Wang
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Xinxin Zhao
- Department of Oncology Radiotherapy, The First People's Hospital of Kerqin District, Tongliao, China
| | - Jinchao Dai
- Department of Nuclear Medicine, Qingdao Central Hospital, Qingdao, China
| | - Haitao Wang
- Department of Oncology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Guanglie Chen
- Department of Oncology Radiotherapy, The First People's Hospital of Kerqin District, Tongliao, China
| | - Ruoyu Wang
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yuqing Song
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, China
| | - Kaixian Zhang
- Department of Oncology, Tengzhou Central People’s Hospital, Tengzhou, China
| | - Xuequan Huang
- Center of Minimally Invasive Intervention, Southwest Hospital of Army Medical University, Chongqing, China,*Correspondence: Shude Chai, ; Xuequan Huang, ; Junjie Wang,
| | - Shude Chai
- Department of Oncology, The Second Hospital of Tianjin Medical University, Tianjin, China,*Correspondence: Shude Chai, ; Xuequan Huang, ; Junjie Wang,
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China,*Correspondence: Shude Chai, ; Xuequan Huang, ; Junjie Wang,
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Kant R, Gupta M, Bisht J, Nautiyal V, Kumar V, Dobhal R, Ahmed M, Saini S. A review article on the dosimetry in intraluminal HDR brachytherapy of lung carcinoma. J Cancer Res Ther 2023; 19:S36-S40. [PMID: 37147980 DOI: 10.4103/jcrt.jcrt_541_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Lung cancer is one of the most common cancers in the world. Intraluminal brachytherapy (BT) is one of the most adopted treatment modalities for lung malignancies with Ir-192 source in radiotherapy. In intraluminal BT, treatment delivery is required to be very accurate and precise with respect to the plan created in the treatment planning system (TPS). The BT dosimetry is necessary for better treatment outcomes. Therefore in this review article, some relevant studies were identified and analyzed for dosimetric outcomes in intraluminal BT in lung malignancies. The dosimetry in BT for plan verification is not presently in practice, which needs to be performed to check the variation between the planned and measured doses. The necessary dosimetric work done by the various researchers in intraluminal BT such as the Monte Carlo CYLTRAN code was used to calculate and measure the dose rate in any medium. Anthropomorphic phantom was used to measure doses at some distance from the source with Thermo luminescence dosimeters (TLDs). The dosimetric influence of air passage in the bronchus was evaluated with the GEANT4 Monte Carlo method. A pinpoint chamber was used to measure and quantify the impact of inhomogeneity in wax phantom for the Ir-192 source. The Gafchromic films and Monte Carlo methods were used to find the phantom and heterogeneities, which were found to underestimate the dose for the lungs and overestimated for the bones in TPS. The exact tool to quantify the variation in planned and delivered doses should be cost-effective and easy to use possibly with tissue equivalent phantoms and Gafchromic films in lung malignancies treatment.
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Cui Y, Yan H, Wang H, Zhang Y, Li M, Cui K, Xiao Z, Liu L, Xie W. CuS- 131I-PEG Nanotheranostics-Induced "Multiple Mild-Hyperthermia" Strategy to Overcome Radio-Resistance in Lung Cancer Brachytherapy. Pharmaceutics 2022; 14:pharmaceutics14122669. [PMID: 36559162 PMCID: PMC9785376 DOI: 10.3390/pharmaceutics14122669] [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: 10/20/2022] [Revised: 11/26/2022] [Accepted: 11/27/2022] [Indexed: 12/05/2022] Open
Abstract
Brachytherapy is one mainstay treatment for lung cancer. However, a great challenge in brachytherapy is radio-resistance, which is caused by severe hypoxia in solid tumors. In this research, we have developed a PEGylated 131I-labeled CuS nanotheranostics (CuS-131I-PEG)-induced "multiple mild-hyperthermia" strategy to reverse hypoxia-associated radio-resistance. Specifically, after being injected with CuS-131I-PEG nanotheranostics, tumors were irradiated by NIR laser to mildly increase tumor temperature (39~40 °C). This mild hyperthermia can improve oxygen levels and reduce expression of hypoxia-induced factor-1α (HIF-1α) inside tumors, which brings about alleviation of tumor hypoxia and reversion of hypoxia-induced radio-resistance. During the entire treatment, tumors are treated by photothermal brachytherapy three times, and meanwhile mild hyperthermia stimulation is conducted before each treatment of photothermal brachytherapy, which is defined as a "multiple mild-hyperthermia" strategy. Based on this strategy, tumors have been completely inhibited. Overall, our research presents a simple and effective "multiple mild-hyperthermia" strategy for reversing radio-resistance of lung cancer, achieving the combined photothermal brachytherapy.
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Affiliation(s)
- Yanna Cui
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hui Yan
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Haoze Wang
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200233, China
| | - Yongming Zhang
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Meng Li
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- College of Chemistry and Materials Science, Shanghai Normal University, Shanghai 200233, China
| | - Kai Cui
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zeyu Xiao
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Correspondence: (Z.X.); (L.L.); (W.X.)
| | - Liu Liu
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Correspondence: (Z.X.); (L.L.); (W.X.)
| | - Wenhui Xie
- Department of Nuclear Medicine, Shanghai Chest Hospital & Department of Pharmacology and Chemical Biology, Translational Medicine Collaborative Innovation Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Correspondence: (Z.X.); (L.L.); (W.X.)
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Endobronchial Therapies for Diagnosis, Staging, and Treatment of Lung Cancer. Surg Clin North Am 2022; 102:393-412. [DOI: 10.1016/j.suc.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Xue H, Qiu B, Wang H, Jiang P, Sukocheva O, Fan R, Xue L, Wang J. Stereotactic Ablative Brachytherapy: Recent Advances in Optimization of Radiobiological Cancer Therapy. Cancers (Basel) 2021; 13:cancers13143493. [PMID: 34298703 PMCID: PMC8304109 DOI: 10.3390/cancers13143493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023] Open
Abstract
Brachytherapy (BT), a type of focal anti-cancer radiotherapy, delivers a highly focused radiation dose to localized tumors, sparing surrounding normal tissues. Recent technological advances have helped to increase the accuracy of BT and, thus, improve BT-based cancer treatment. Stereotactic ablative brachytherapy (SABT) was designed to improve the ablative effect of radiation, which was achieved via improved image guidance, and calculation of ablative dose, shorter treatment duration, and better organ preservation. Recently collected data characterized SABT as having the potential to cure various early-stage cancers. The method provides higher tumor control rate levels that were previously achievable only by surgical resection. Notably, SABT is suitable for application with unresectable malignancies. However, the pathological assessment of SABT irradiated tumors is limited due to difficulties in specimen acquisition. Prostate, lung, liver, and gynecological cancers are the most commonly reported SABT-treated malignancies. This study will give an overview of SABT, focusing on the advances in SABT optimization, and provide insights on the future benefits of the combined application of SABT with cancer immunotherapies.
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Affiliation(s)
- Hui Xue
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Bin Qiu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Hao Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Olga Sukocheva
- Discipline of Health Sciences, College of Nursing and Health Sciences, Flinders University of South Australia, Bedford Park, SA 5042, Australia;
| | - Ruitai Fan
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;
| | - Lixiang Xue
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
- Correspondence: (L.X.); (J.W.); Tel.: +86-13701076310 (L.X.); +86-13701076310 (J.W.)
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
- Correspondence: (L.X.); (J.W.); Tel.: +86-13701076310 (L.X.); +86-13701076310 (J.W.)
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