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Yang X, Liao Y, Fan L, Lin B, Li J, Wu D, Liao D, Yuan L, Liu J, Gao F, Feng G, Du X. High-intensity focused ultrasound ablation combined with immunotherapy for treating liver metastases: A prospective non-randomized trial. PLoS One 2024; 19:e0306595. [PMID: 38968190 PMCID: PMC11226133 DOI: 10.1371/journal.pone.0306595] [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: 01/27/2024] [Accepted: 06/18/2024] [Indexed: 07/07/2024] Open
Abstract
PURPOSE Given the unique features of the liver, it is necessary to combine immunotherapy with other therapies to improve its efficacy in patients of advanced cancer with liver metastases (LM). High-intensity focused ultrasound (HIFU) ablation is now widely used in clinical practice and can enhanced immune benefits. The study is intended to prospectively evaluate the safety and clinical feasibility of HIFU ablation in combination with systemic immunotherapy for patients with liver metastases. METHODS The study enrolled 14 patients with LM who received ultrasound-guided HIFU ablation combined with immune checkpoint inhibitors (ICIs) such as anti-programmed cell death protein 1 (anti-PD-1 agents manufactured in China) at Mianyang Central Hospital. Patients were followed up for adverse events (AEs) during the trial, using the CommonTerminology Criteria for Adverse Events v5.0(CTCAE v5.0) as the standard. Tumour response after treatment was assessed using computerized tomography. RESULTS The 14 patients (age range, 35-84 years) underwent HIFU ablation at 19 metastatic sites and systemic immunotherapy. The mean lesion volume was 179.9 cm3 (maximum: 733.1 cm3). Median follow-up for this trial was 9 months (range: 3-21) months. The study is clinically feasible and acceptable to patients. CONCLUSION This prospective study confirmed that HIFU combined with immunotherapy is clinically feasible and safe for treating liver metastases.
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Affiliation(s)
- Xiyue Yang
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Yao Liao
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Lingli Fan
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Binwei Lin
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Jie Li
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Danfeng Wu
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Dongbiao Liao
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Li Yuan
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Jihui Liu
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Feng Gao
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Gang Feng
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
| | - Xiaobo Du
- Department of Oncology, Mianyang Central Hospital, Mianyang, China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Sichuan Clinical Research Center for Radiation and Therapy, Mianyang, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
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Han ZY, Dou JP, Cheng ZG, Liu FY, Yu J, Yu XL, Liang P. Efficacy and safety of percutaneous ultrasound-guided microwave ablation for cervical metastatic lymph nodes from papillary thyroid carcinoma. Int J Hyperthermia 2020; 37:971-975. [PMID: 32781871 DOI: 10.1080/02656736.2020.1805128] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Zhi-Yu Han
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Jian-Ping Dou
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
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Assessment of Liver Metastases Using CT and MRI Scans in Patients with Pancreatic Ductal Adenocarcinoma: Effects of Observer Experience on Diagnostic Accuracy. Cancers (Basel) 2020; 12:cancers12061455. [PMID: 32503262 PMCID: PMC7352533 DOI: 10.3390/cancers12061455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to investigate the impact of radiologic experience on the diagnostic accuracy of computed tomography (CT) vs. magnetic resonance imaging (MRI) reporting on the liver metastases of pancreatic ductal adenocarcinoma (LM of PDAC). Intra-individual CT and MRI examinations of 112 patients with clinically proven LM of PDAC were included. Four radiologists with varying years of experience (A > 20, B > 5, C > 1 and D < 1) assessed liver segments affected by LM of PDAC, as well as associated metastases occurring in each patient. Their sensitivity and specificity in evaluating the segments were compared. Cohen’s Kappa (κ) for diagnosed liver segments and Intra-class Correlation Coefficients (ICC) for the number of metastatic lesions in each patient were calculated. The radiologists’ sensitivity and specificity for the CT vs. MRI were, respectively: Reader A—94.4%, 90.3% vs. 96.6%, 94.8%; B—86.7%, 79.7% vs. 83.9%, 82.0%; C—78.0%, 76.7% vs. 83.3%, 78.9% and D—71.8%, 79.2% vs. 64.0%, 69.5%. Reviewers A and B achieved greater agreement in assessing results from the MRI (κ = 0.72, p < 0.001; ICC = 0.73, p < 0.001) vs. the CT (κ = 0.58, p < 0.001; ICC = 0.61, p < 0.001), in contrast to readers C and D (MRI: κ = 0.34, p < 0.001; ICC = 0.42, p < 0.001, and CT: κ = 0.48, p < 0.001; ICC = 0.59, p < 0.001). Our results indicate that the accurate diagnosis of LM of PDAC depends more on radiologic experience in MRI over CT scans.
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Li S, Sun S, Xiang H, Yang J, Peng M, Gao Q. Liver metastases and the efficacy of the PD-1 or PD-L1 inhibitors in cancer: a meta-analysis of randomized controlled trials. Oncoimmunology 2020; 9:1746113. [PMID: 32313724 PMCID: PMC7153839 DOI: 10.1080/2162402x.2020.1746113] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/17/2020] [Accepted: 02/28/2020] [Indexed: 12/18/2022] Open
Abstract
Objective: To explore the relations between liver metastases (LM) and the efficacy of the treatments with programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitors. Method: Pubmed, Embase, American Society of Clinical Oncology and the European Society for Medical Oncology were searched to select eligible studies about PD-1 or PD-L1 inhibitors (Nivolumab, Pembrolizumab, Cemiplimab, Avelumab, Durvalumab, and Atezolizumab). We included only the original randomized controlled trials (RCTs), including the hazard ratios (HR) of death in both patients with LM and patients without LM. Then the data were extracted for the meta-analysis. Subgroup analyses of cancer types and drug types were also performed. Results: 5293 patients [1246 (24%) patients with LM, and 4047 (76%) patients without LM] from the eight RCTs were included for the final analysis. The pooled hazard ratio (HR) of death in the patients with LM was 0.82 (95% CI, 0.71 to 0.93, P = .003) while the pooled HR in the patients without LM was 0.72 (95% CI, 0.66 to 0.79, P < .001). Additionally, no significant difference was found between the two groups (P = .137). Conclusion: No statistically significant association of liver metastases with the efficacy of treatments with PD-1 or PD-L1 inhibitors in the treatment of advanced or metastatic cancer was found in the stratified analyses. Moreover, future studies about the safety of the PD-1 or PD-L1 inhibitors in patients with or without liver metastases are warranted.
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Affiliation(s)
- Shan Li
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shanquan Sun
- Department of Anatomy, Chongqing Medical University, Chongqing, China
| | - Hui Xiang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jing Yang
- The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Minyong Peng
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Gao
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Kouri BE. Interventional Oncology: Optimizing Transarterial Therapies for the Treatment of Hepatic Malignancy. Tech Vasc Interv Radiol 2018; 21:205-222. [DOI: 10.1053/j.tvir.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Hoang NS, Khalaf MH, Rosenberg JK, Kwofie J, Reposar AL, Wang DS, Louie JD, Sze DY. Quantification of Activity Lost to Delivery-System Residual and Decay in Yttrium-90 Radioembolization. J Vasc Interv Radiol 2018; 29:1672-1677. [DOI: 10.1016/j.jvir.2018.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/11/2018] [Accepted: 07/15/2018] [Indexed: 12/20/2022] Open
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Tian G, Zhao Q, Chen F, Jiang T, Wang W. Ablation of hepatic malignant tumors with irreversible electroporation: A systematic review and meta-analysis of outcomes. Oncotarget 2018; 8:5853-5860. [PMID: 28009979 PMCID: PMC5351595 DOI: 10.18632/oncotarget.14030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/28/2016] [Indexed: 12/18/2022] Open
Abstract
Background Irreversible electroporation (IRE) ablation is a new technique that is used to eliminate malignant tumors through nonthermal approaches. Objective The purpose of this review was to evaluate the efficiency of IRE for hepatic malignant tumors. Methods A systematic search was performed from PubMed, Embase, Web of science, Scopus and other potential literatures from references in relevant articles July 26th, 2016. Overall estimates of pooled standard mean difference (SMD) with 95% confidence interval (CI) were calculated for the changes of the pre- and post-IRE longest diameter, alkaline phosphatase (ALP), aspartate aminotransferase (AST) and serum total bilirubin levels. Sensitivity analysis and publication bias and were performed after the pooled analysis, and the quality of the included literatures was appraised using Newcastle-Ottawa Scale (NOS). Results We finally included 300 patients (mean age: 51 to 66.6 years; male: 182; female: 118) from 9 studies of hepatic malignant tumors. The meta-analysis showed that comparing with the initial values, the longest diameter of the tumors was significantly decreased at the last follow-up months after IRE. Furthermore, the ALP, AST and total bilirubin levels were increased at 1 day after IRE while returned to baseline at the last follow-up month. No risk of publication bias was found, and all literatures were assessed good quality according to NOS. Conclusions The pooled data indicated that IRE could be a minimal invasive and effective approach for patients who had preoperative poor liver function or those whose masses were in refractory locations where surgical resection was unsuitable.
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Affiliation(s)
- Guo Tian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Qiyu Zhao
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Fen Chen
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Tian'an Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Weilin Wang
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.,Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Abstract
OPINION STATEMENT Percutaneous thermal ablation, including microwave ablation (MWA), radiofrequency ablation (RFA), and cryoablation, is a well-established focal treatment option for primary and metastatic malignancies. While published literature specific to ablation of sarcomas is relatively lacking compared with non-sarcomatous malignancies, what is available is promising. In situations where a focal treatment option is desired, strong consideration should be given to percutaneous thermal ablation, in addition to surgery and radiation therapy. A significant advantage of percutaneous thermal ablation over surgery and radiation includes the repeatability of ablation, as there is no absolute limit on the number of times an ablation can be performed. Compared with surgery, ablation offers the potential of decreased recovery time, a less invasive procedure, and is often performed in patients deemed not medically fit for surgery.
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