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He JY, Yang L, Wang DD. Efficacy and Safety of thermal ablation for Patients With stage I non-small cell lung cancer. Acad Radiol 2024:S1076-6332(24)00349-0. [PMID: 38942645 DOI: 10.1016/j.acra.2024.05.038] [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: 04/17/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/30/2024]
Abstract
RATIONALE AND OBJECTIVES The objective of this study was to measure the safety and efficacy of thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), for patients with stage I non-small cell lung cancer (NSCLC). MATERIALS AND METHODS The databases PubMed was searched from inception to November 2023 to identify relevant studies. Statistical analyses were performed with R version 3. 6. 3. RESULTS Thirty-three studies involving 1400 patients were finally included. According to our study, the incidence of patients with stage I NSCLC who were older than 60 years old was 98 % (95 % CI [94-100 %]); the lesions were mostly located in RUL (Right Upper Lobe) and LUL (Left Upper Lobe), and the incidence of the two sites was 29 % (95 % CI [23-35 %]) and 27 % (95 % CI [21-33 %]), respectively; the types of lung cancers mainly included adenocarcinoma, squamous carcinoma, and large-cell lung cancer, of which adenocarcinoma accounted for the largest proportion of 63 % (95 % CI [56-70 %]); the causes of death were mainly categorized into cancer-related (57 %, 95 %CI[40-74 %]) and noncancer-related (40 %, 95 %CI [23-58 %]); the common complications in the postoperative period were pneumothorax and pain, with the incidence of 33 % (95 %CI[24-44 %]) and 33 % (95 %CI[19-50 %]), and the rate of the postoperative complications in MWA was slightly higher than those in RFA; the local recurrence rate was 23 % (95 %CI[17-29 %]) and the distant recurrence rate was 18 % (95 %CI[7-32 %]); the pooling result showed the rate of 1-, 2-, 3-, and 5-year survival rate were 96 %, 81 %, 68 %, and 42 %, the Cancer-specific survival (CSS) rates at 1, 2, 3, and 5 years were 98 %, 88 %, 75 %, and 58 %, Disease-free survival (DFS) rates at 1, 2, 3, and 5 years were 87 %, 63 %, 57 %, and 42 %, there were no significant differences existed between the RFA group and MWA group in survival rate, CSS and DFS. CONCLUSION Ablation therapy is safe and effective for stage I NSCLC patient. MWA and RFA have comparable efficacy, safety, and prognosis, which could be recommended for patients with stageⅠNSCLC, especially for patients who cannot tolerate open surgery.
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Affiliation(s)
- Jin-Ying He
- Department of Radiology, Qingdao Municipal Hospital China
| | - Ling Yang
- Department of Interventional Oncology, Qingdao Municipal Hospital China
| | - Dong-Dong Wang
- Department of Interventional Oncology, Qingdao Municipal Hospital China.
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Han X, Wang X, Li Z, Dou W, Shi H, Liu Y, Sun K. Risk prediction of intraoperative pain in percutaneous microwave ablation of lung tumors under CT guidance. Eur Radiol 2023; 33:8693-8702. [PMID: 37382619 DOI: 10.1007/s00330-023-09874-9] [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: 08/19/2022] [Revised: 04/05/2023] [Accepted: 05/04/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To evaluate the effect of intraoperative pain in microwave ablation of lung tumors (MWALT) on local efficacy and establish the pain risk prediction model. METHODS It was a retrospectively study. Consecutive patients with MWALT from September 2017 to December 2020 were divided into mild and severe pain groups. Local efficacy was evaluated by comparing technical success, technical effectiveness, and local progression-free survival (LPFS) in two groups. All cases were randomly allocated into training and validation cohorts at a ratio of 7:3. A nomogram model was established using predictors identified by logistics regression in training dataset. The calibration curves, C-statistic, and decision curve analysis (DCA) were used to evaluate the accuracy, ability, and clinical value of the nomogram. RESULTS A total of 263 patients (mild pain group: n = 126; severe pain group: n = 137) were included in the study. Technical success rate and technical effectiveness rate were 100% and 99.2% in the mild pain group and 98.5% and 97.8% in the severe pain group. LPFS rates at 12 and 24 months were 97.6% and 87.6% in the mild pain group and 91.9% and 79.3% in the severe pain group (p = 0.034; HR: 1.90). The nomogram was established based on three predictors: depth of nodule, puncture depth, and multi-antenna. The prediction ability and accuracy were verified by C-statistic and calibration curve. DCA curve suggested the proposed prediction model was clinically useful. CONCLUSIONS Severe intraoperative pain in MWALT reduced the local efficacy. An established prediction model could accurately predict severe pain and assist physicians in choosing a suitable anesthesia type. CLINICAL RELEVANCE STATEMENT This study firstly provides a prediction model for the risk of severe intraoperative pain in MWALT. Physicians can choose a suitable anesthesia type based on pain risk, in order to improve patients' tolerance as well as local efficacy of MWALT. KEY POINTS • The severe intraoperative pain in MWALT reduced the local efficacy. • Predictors of severe intraoperative pain in MWALT were the depth of nodule, puncture depth, and multi-antenna. • The prediction model established in this study can accurately predict the risk of severe pain in MWALT and assist physicians in choosing a suitable anesthesia type.
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Affiliation(s)
- Xujian Han
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China.
| | - Zhenjia Li
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China.
| | - Weitao Dou
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Honglu Shi
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Yuanqing Liu
- Department of Medical Intervention, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
| | - Kui Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan, Shandong, China
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Kim DH, Gilyard S, Suh R. Special Considerations and Techniques of Interventions in Lung Transplant Recipients. Tech Vasc Interv Radiol 2023; 26:100926. [PMID: 38123291 DOI: 10.1016/j.tvir.2023.100926] [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] [Indexed: 12/23/2023]
Abstract
Lung transplant remains an important treatment option for patients with end-stage lung diseases providing improvement in survival rates and quality of life. Specialized considerations should be applied with interventions of lung transplant recipients as they host specific anatomic variations and high risk towards certain complications. In this article, we highlight the role of interventional radiology for lung transplant recipients along with discussion of interventional techniques. Specific emphasis is placed on describing and explaining the techniques pertained to the points of anastomosis, diagnosis and treatment of malignancies, and management of complications in lung transplant recipients.
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Affiliation(s)
- Daniel H Kim
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Shenise Gilyard
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Robert Suh
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA.
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Laeseke P, Ng C, Ferko N, Naghi A, Wright GWJ, Zhang Y, Laidlaw A, Kalsekar I, Laxmanan B, Ghosh SK, Zhou M, Szapary P, Pritchett M. Stereotactic body radiation therapy and thermal ablation for treatment of NSCLC: A systematic literature review and meta-analysis. Lung Cancer 2023; 182:107259. [PMID: 37321074 DOI: 10.1016/j.lungcan.2023.107259] [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: 02/20/2023] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 06/17/2023]
Abstract
RATIONALE Stereotactic body radiation therapy (SBRT) is the standard of care for inoperable early stage non-small cell lung cancer (NSCLC). Use of image guided thermal ablation (IGTA; including microwave ablation [MWA] and radiofrequency ablation [RFA]) has increased in NSCLC, however there are no studies comparing all three. OBJECTIVE To compare the efficacy of IGTA (including MWA and RFA) and SBRT for the treatment of NSCLC. METHODS Published literature databases were systematically searched for studies assessing MWA, RFA, or SBRT. Local tumor progression (LTP), disease-free survival (DFS), and overall survival (OS) were assessed with single-arm pooled analyses and meta-regressions in NSCLC patients and a stage IA subgroup. Study quality was assessed with a modified methodological index for non-randomized studies (MINORS) tool. RESULTS Forty IGTA study-arms (2,691 patients) and 215 SBRT study-arms (54,789 patients) were identified. LTP was lowest after SBRT at one and two years in single-arm pooled analyses (4% and 9% vs. 11% and 18%) and at one year in meta-regressions when compared to IGTA (OR = 0.2, 95%CI = 0.07-0.63). MWA patients had the highest DFS of all treatments in single-arm pooled analyses. In meta-regressions at two and three-years, DFS was significantly lower for RFA compared to MWA (OR = 0.26, 95%CI = 0.12-0.58; OR = 0.33, 95%CI = 0.16-0.66, respectively). OS was similar across modalities, timepoints, and analyses. Older age, male patients, larger tumors, retrospective studies, and non-Asian study region were also predictors of worse clinical outcomes. In high-quality studies (MINORS score ≥ 7), MWA patients had better clinical outcomes than the overall analysis. Stage IA MWA patients had lower LTP, higher OS, and generally lower DFS, compared to the main analysis of all NSCLC patients. CONCLUSIONS NSCLC patients had comparable outcomes after SBRT and MWA, which were better than those with RFA.
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Affiliation(s)
- Paul Laeseke
- Radiology, University of Wisconsin, Madison, WI, United States.
| | - Calvin Ng
- Department of Surgery, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China.
| | | | | | | | | | | | - Iftekhar Kalsekar
- Lung Cancer Initiative, Johnson & Johnson, New Brunswick, NJ, United States.
| | - Balaji Laxmanan
- Lung Cancer Initiative, Johnson & Johnson, New Brunswick, NJ, United States.
| | - Sudip K Ghosh
- Health Economics and Market Access, Johnson & Johnson, Cincinnati, OH, United States.
| | - Meijia Zhou
- Lung Cancer Initiative, Johnson & Johnson, New Brunswick, NJ, United States.
| | - Philippe Szapary
- Lung Cancer Initiative, Johnson & Johnson, New Brunswick, NJ, United States.
| | - Michael Pritchett
- Pulmonary and Critical Care Medicine, FirstHealth Moore Regional Hospital, and Pinehurst Medical Clinic, Pinehurst, NC, United States.
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Xu S, Bie ZX, Li YM, Li B, Peng JZ, Kong FL, Li XG. Computed tomography-guided microwave ablation for non-small cell lung cancer patients on antithrombotic therapy: a retrospective cohort study. Quant Imaging Med Surg 2022; 12:3251-3263. [PMID: 35655826 PMCID: PMC9131327 DOI: 10.21037/qims-21-1043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/14/2022] [Indexed: 10/05/2023]
Abstract
BACKGROUND For non-small cell lung cancer (NSCLC) patients on antithrombotic therapy who are treated with microwave ablation (MWA), the transient interruption of antithrombotic agents may increase the risk of thromboembolism, and continuation of antithrombotic agents may increase the risk of intraprocedural hemorrhage. This retrospective cohort study aimed to explore the safety of MWA in patients with NSCLC on antithrombotic therapy. METHODS A total of 572 patients with NSCLC (antithrombotic therapy group: n=84, Group A; control group: n=488, Group B) who received MWA were included. Antithrombotic agent use was suspended before MWA and resumed as soon as possible after MWA. Hemorrhagic (hemothorax and hemoptysis) and thromboembolic complications (pulmonary embolism, cerebral infarction, and angina) were compared. Logistic regression analyses were used to investigate the predictors of hemorrhagic complications after MWA. RESULTS Hemorrhagic complications occurred in 8 participants (9.5%) from Group A and 33 participants (6.8%) from Group B, and no statistically significant difference was found (P=0.365). There were 3 participants (0.5%) who developed thromboembolic complications, including 1 case (1.2%, 1/84) of pulmonary embolism in Group A, and 2 cases (0.4%, 2/488) of cerebral infarction or angina in Group B; no significant difference was found (P=0.923). In the subgroup analyses of Group A, no statistically significant difference of hemorrhagic (P>0.999) or thromboembolic complications (P>0.999) was found between patients who received and did not receive bridging anticoagulation with heparin. Logistic regression analyses revealed that direct contact of a tumor with vessels ≥2 mm was a predictor of hemorrhagic complications [hazard ratio (HR) =2.318; 95% confidence interval (CI): 1.215-4.420; P=0.011], while antithrombotic therapy was irrelevant. CONCLUSIONS With the appropriate cessation and resumption of antithrombotic agents, patients with NSCLC on antithrombotic therapy have comparable incidence rates of hemorrhagic and thromboembolic complications after MWA to those of patients who are not on antithrombotic therapy. Therefore, with appropriate cessation, MWA appears to generally be safe for NSCLC patients on antithrombotic therapy.
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Affiliation(s)
- Sheng Xu
- Department of 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
| | - Zhi-Xin Bie
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuan-Ming Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jin-Zhao Peng
- Department of 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
| | - Fan-Lei Kong
- Department of 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
| | - Xiao-Guang Li
- Department of 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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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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Xie F, Chen J, Jiang Y, Sun J, Hogarth DK, Herth FJF. Microwave ablation via a flexible catheter for the treatment of nonsurgical peripheral lung cancer: A pilot study. Thorac Cancer 2022; 13:1014-1020. [PMID: 35166043 PMCID: PMC8977152 DOI: 10.1111/1759-7714.14351] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 12/11/2022] Open
Abstract
Background Endobronchial microwave ablation via flexible catheter offers the potential for local therapy for inoperable peripheral lung cancer. The study aimed to evaluate the feasibility and safety of navigation bronchoscopy‐guided water‐cooled microwave ablation catheter for nonsurgical peripheral lung cancer. Methods This was a prospective single arm pilot study. Patients with early stage or multiple primary peripheral lung cancer who were nonsurgical candidates for surgery were enrolled in the study. Bronchoscopic microwave ablation was performed via a flexible water‐cooled microwave ablation antenna under the guidance of navigation bronchoscopy. Radial probe endobronchial ultrasound combined with fluoroscopy was used to confirm the position. Treatment outcomes were evaluated based on follow‐up chest CT and positron emission tomography scans. Primary endpoints were technical success and safety. Secondary endpoints were complete ablation rate, 2‐year local control rate, and progression‐free survival. Results Thirteen patients were enrolled in the study from April 2018 to July 2019. A total of 19 sessions of microwave ablation were performed on 14 tumors under the guidance of navigation bronchoscopy. The technical success was 100%. Treatment‐related complications occurred in two patients. The complete ablation rate was 78.6% (11/14). The 2‐year local control rate was 71.4%. Median progression‐free survival was 33 months for all patients. Conclusions In this pilot study, bronchoscopic microwave ablation appears to be feasible with acceptable occurrence of complication in the treatment of peripheral lung cancer under the guidance of navigation bronchoscopy.
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Affiliation(s)
- Fangfang Xie
- Department of Respiratory Endoscopy, Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Junxiang Chen
- Department of Respiratory Endoscopy, Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Yifeng Jiang
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jiayuan Sun
- Department of Respiratory Endoscopy, Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - D Kyle Hogarth
- Department of Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Felix J F Herth
- Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany
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Geoghegan R, Ter Haar G, Nightingale K, Marks L, Natarajan S. Methods of monitoring thermal ablation of soft tissue tumors - A comprehensive review. Med Phys 2022; 49:769-791. [PMID: 34965307 DOI: 10.1002/mp.15439] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 11/30/2020] [Accepted: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
Thermal ablation is a form of hyperthermia in which oncologic control can be achieved by briefly inducing elevated temperatures, typically in the range 50-80°C, within a target tissue. Ablation modalities include high intensity focused ultrasound, radiofrequency ablation, microwave ablation, and laser interstitial thermal therapy which are all capable of generating confined zones of tissue destruction, resulting in fewer complications than conventional cancer therapies. Oncologic control is contingent upon achieving predefined coagulation zones; therefore, intraoperative assessment of treatment progress is highly desirable. Consequently, there is a growing interest in the development of ablation monitoring modalities. The first section of this review presents the mechanism of action and common applications of the primary ablation modalities. The following section outlines the state-of-the-art in thermal dosimetry which includes interstitial thermal probes and radiologic imaging. Both the physical mechanism of measurement and clinical or pre-clinical performance are discussed for each ablation modality. Thermal dosimetry must be coupled with a thermal damage model as outlined in Section 4. These models estimate cell death based on temperature-time history and are inherently tissue specific. In the absence of a reliable thermal model, the utility of thermal monitoring is greatly reduced. The final section of this review paper covers technologies that have been developed to directly assess tissue conditions. These approaches include visualization of non-perfused tissue with contrast-enhanced imaging, assessment of tissue mechanical properties using ultrasound and magnetic resonance elastography, and finally interrogation of tissue optical properties with interstitial probes. In summary, monitoring thermal ablation is critical for consistent clinical success and many promising technologies are under development but an optimal solution has yet to achieve widespread adoption.
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Affiliation(s)
- Rory Geoghegan
- Department of Urology, University of California Los Angeles, Los Angeles, California, USA
| | - Gail Ter Haar
- Department of Physics, Institute of Cancer Research, University of London, Sutton, UK
| | - Kathryn Nightingale
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Leonard Marks
- Department of Urology, University of California Los Angeles, Los Angeles, California, USA
| | - Shyam Natarajan
- Departments of Urology & Bioengineering, University of California Los Angeles, Los Angeles, California, USA
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Xu S, Qi J, Bie ZX, Li YM, Li B, Guo RQ, Li XG. Local progression after computed tomography-guided microwave ablation in non-small cell lung cancer patients: prediction using a nomogram model. Int J Hyperthermia 2021; 38:1366-1374. [PMID: 34514949 DOI: 10.1080/02656736.2021.1976852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To develop an effective nomogram model for predicting the local progression after computed tomography-guided microwave ablation (MWA) in non-small cell lung cancer (NSCLC) patients. METHODS NSCLC patients treated with MWA were randomly allocated to either the training cohort or the validation cohort (4:1). The predictors of local progression identified by univariable and multivariable analyses in the training cohort were used to develop a nomogram model. The C-statistic was used to evaluate the predictive accuracy in both the training and validation cohorts. RESULTS A total of 304 patients (training cohort: n = 250; validation cohort: n = 54) were included in this study. The predictors selected into the nomogram for local progression included the tumor subtypes (odds ratio [OR], 2.494; 95% confidence interval [CI], 1.415-4.396, p = 0.002), vessels ≥3 mm in direct contact with tumor (OR, 2.750; 95% CI, 1.263-5.988; p = 0.011), tumor diameter (OR, 2.252; 95% CI, 1.034-4.903; p = 0.041) and location (OR, 2.442; 95% CI, 1.201-4.965; p = 0.014). The C-statistic showed good predictive performance in both cohorts, with a C-statistic of 0.777 (95% CI, 0.707-0.848) internally and 0.712 (95% CI, 0.570-0.855) externally (training cohort and validation cohort, respectively). The optimal cutoff value for the risk of local progression was 0.39. CONCLUSIONS Tumor subtypes, vessels ≥3 mm in direct contact with the tumor, tumor diameter and location were predictors of local progression after MWA in NSCLC patients. The nomogram model could effectively predict the risk of local progression after MWA. Patients showing a high risk (>0.39) on the nomogram should be monitored for local progression.
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Affiliation(s)
- Sheng Xu
- Department of 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
| | - Jing Qi
- School of Medicine, Nankai University, Tianjin, China
| | - Zhi-Xin Bie
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuan-Ming Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Run-Qi Guo
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao-Guang Li
- Department of 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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Xu S, Bie ZX, Li YM, Li B, Guo RQ, Li XG. Computed tomography-guided microwave ablation for the treatment of non-small cell lung cancer patients with and without adjacent lobe invasion: A comparative study. Thorac Cancer 2021; 12:2780-2788. [PMID: 34427998 PMCID: PMC8520792 DOI: 10.1111/1759-7714.14125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The aim of the study was to explore the outcomes of computed tomography-guided microwave ablation (MWA) in non-small cell lung cancer (NSCLC) patients with adjacent lobe invasion (ALI), and to compare the outcomes of ALI-NSCLC and non-ALI NSCLC patients after MWA. METHODS A total of 319 NSCLC patients and 366 tumors treated with MWA were included in the study, comprising 34 ALI-NSCLC patients and 285 non-ALI NSCLC patients. Complications, local recurrence rates, progression-free survival (PFS), and overall survival (OS) were compared. Logistic regression analyses were used to investigate the correlation between ALI and the occurrence of pneumothorax after MWA. RESULTS The mean tumor diameter of ablated tumors was 3.6 ± 2.2 cm. There were 95 (29.8%) NSCLC patients in which pneumothorax occurred after MWA, and all patients recovered. Of these, the ALI group had a significantly higher incidence rate of pneumothorax than the non-ALI group (52.9% vs. 27.0%, p = 0.002). The median PFS and OS for the ALI group were 12.0 ± 10.2 and 15.5 ± 9.5 months, respectively, and that of the non-ALI group were 13.0 ± 10.6 and 17.0 ± 11.1 months, respectively, and no significant difference was found in PFS (p = 0.329) nor OS (p = 0.394) between the two groups. Local recurrence rates for ALI and non-ALI groups were 29.4% and 20.7%, respectively, and no significant difference was found (p = 0.244). Logistic regression analyses revealed that ALI can increase the risk of pneumothorax (hazard ratio [HR], 2.867; p = 0.012). CONCLUSIONS MWA is an effective and safe approach for ALI-NSCLC treatment. Although ALI can increase the risk of pneumothorax, ALI-NSCLC patients reveal a comparable outcome to non-ALI NSCLC patients after MWA.
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Affiliation(s)
- Sheng Xu
- Department of 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
| | - Zhi-Xin Bie
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuan-Ming Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Run-Qi Guo
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao-Guang Li
- Department of 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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11
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Xu S, Qi J, Li B, Bie ZX, Li YM, Li XG. Risk prediction of pneumothorax in lung malignancy patients treated with percutaneous microwave ablation: development of nomogram model. Int J Hyperthermia 2021; 38:488-497. [PMID: 33754941 DOI: 10.1080/02656736.2021.1902000] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To develop effective nomograms for predicting pneumothorax and delayed pneumothorax after microwave ablation (MWA) in lung malignancy (LM) patients. METHODS LM patients treated with MWA were randomly allocated to a training or validation cohort at a ratio of 7:3. The predictors of pneumothorax identified by univariate and multivariate analyses in the training cohort were used to develop a predictive nomogram. The C-statistic was used to evaluate predictive accuracy in both cohorts. A second nomogram for predicting delayed pneumothorax was developed and validated using identical methods. RESULTS A total of 552 patients (training cohort: n = 402; validation cohort: n = 150) were included; of these patients, 27.9% (154/552) developed pneumothorax, with immediate and delayed pneumothorax occurring in 18.8% (104/552) and 9.1% (50/552), respectively. The predictors selected for the nomogram of pneumothorax were emphysema (hazard ratio [HR], 6.543; p < .001), history of lung ablation (HR, 7.841; p= .025), number of pleural punctures (HR, 1.416; p < .050), ablation zone encompassing pleura (HR, 10.225; p < .001) and pulmonary fissure traversed by needle (HR, 10.776; p < .001). The C-statistics showed good predictive performance in the training and validation cohorts (0.792 and 0.832, respectively). Another nomogram for delayed pneumothorax was developed based on emphysema (HR, 2.952; p= .005), ablation zone encompassing pleura (HR, 4.915; p < .001) and pulmonary fissure traversed by needle (HR, 4.348; p = .015). The C-statistics showed good predictive performance in the training cohort, and it had efficacy for prediction in the validation cohort (0.719 and 0.689, respectively). CONCLUSIONS The nomograms could effectively predict the risk of pneumothorax and delayed pneumothorax after MWA.
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Affiliation(s)
- Sheng Xu
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Jing Qi
- School of Medicine, Nankai University, Tianjin, PR China
| | - Bin Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Zhi-Xin Bie
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Yuan-Ming Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Xiao-Guang Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China
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12
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Xu S, Qi J, Li B, Li XG. Survival prediction for non-small cell lung cancer patients treated with CT-guided microwave ablation: development of a prognostic nomogram. Int J Hyperthermia 2021; 38:640-649. [PMID: 33882774 DOI: 10.1080/02656736.2021.1914353] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To explore the outcomes of CT-guided percutaneous microwave ablation (MWA) in non-small cell lung cancer (NSCLC) patients, and then develop an effective nomogram to predict the survival. METHODS NSCLC patients treated with MWA were randomly allocated to either the training cohort or the validation cohort (3:1). The primary outcome measurement was overall survival (OS), whose predictors were identified by univariate and multivariate analyses in the training cohort. Then, a predictive nomogram was developed to predict the OS, with the predictive accuracy evaluated by C-statistic and receiver operating characteristic in both the training and validation cohorts. RESULTS A total of 234 patients (training cohort: n = 176; validation cohort: n = 58) and 271 tumors with a median OS of 17.0 ± 12.2 months were included. The predictors selected into the nomogram included tumor diameter (hazard ratio [HR], 2.12; 95% confidence interval [CI], 1.37-3.30; p < 0.001), extrapulmonary metastases (HR, 1.77; 95% CI, 1.06-2.95; p = 0.030), tumor stage (HR, 1.38; 95% CI, 1.07-1.79; p = 0.013), tumor type (HR, 2.00; 95% CI, 1.48-2.72; p < 0.001) and post-MWA TKIs (HR, 0.55; 95% CI, 0.34-0.89; p < 0.001), based on the results of univariate and multivariate analyses. The C-statistic showed good predictive performance, with a C-statistic of 0.838 (95% CI, 0.779-0.897) internally and 0.808 (95% CI, 0.695-0.920) externally (training cohort and validation cohort, respectively). CONCLUSIONS The nomogram was effective in predicting the OS in NSCLC patients treated with MWA, and could be applied to identify patients who may benefit most from MWA and be helpful for clinical decision making.
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Affiliation(s)
- Sheng Xu
- Department of 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
| | - Jing Qi
- School of Medicine, Nankai University, Tianjin, China
| | - Bin Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao-Guang Li
- Department of 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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13
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Shen X, Chen T, Yang B, Liu N, Qian X, Xia B, Feng D, Chen S. Magnetic resonance imaging-guided microwave ablation for lung tumor: a case report. Quant Imaging Med Surg 2021; 11:2780-2784. [PMID: 34079742 DOI: 10.21037/qims-20-667] [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] [Indexed: 12/19/2022]
Abstract
Thoracoscopic surgery is considered to be the best treatment option for pulmonary lesions. However, for patients with clinical stage IIIA, surgery is not always feasible, due to a lack of sufficient lung function. Microwave ablation (MWA) is an appropriate, minimally invasive treatment option for these patients. In this case study, we present our initial experience with MWA guided by magnetic resonance imaging (MRI), in a patient with a lesion located in the right lower lobe. The patient was successfully ablated and achieved a long progression-free period.
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Affiliation(s)
- Xiaokang Shen
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China.,The Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Tianming Chen
- Department of General Surgery, Nanjing Medical University Third Affiliated Hospital, Nanjing, China
| | - Bo Yang
- Department of Medical Imaging, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Nianlong Liu
- Department of Medical Imaging, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaowei Qian
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Bin Xia
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Dongjie Feng
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Shilin Chen
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China.,The Fourth Clinical College of Nanjing Medical University, Nanjing, China
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14
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Xu S, Bie ZX, Li YM, Li B, Guo RQ, Li XG. A Comparative Study of Cavitary and Noncavitary Non-small Cell Lung Cancer Patients Treated with CT-Guided Microwave Ablation. J Vasc Interv Radiol 2021; 32:1170-1178. [PMID: 34033905 DOI: 10.1016/j.jvir.2021.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/26/2021] [Accepted: 05/09/2021] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To explore the outcomes of computed tomography‒guided microwave (MW) ablation in patients with cavitary non-small cell lung cancer (NSCLC) and to compare the outcomes of cavitary and noncavitary NSCLC treated with MW ablation. MATERIALS AND METHODS A total of 317 patients with NSCLC (194 men and 123 women) treated with MW ablation were include: 19 patients with cavitary NSCLC and 298 patients with noncavitary NSCLC. Complications, progression-free survival (PFS), and overall survival (OS) were evaluated and compared between the 2 groups. The Kaplan-Meier method was used to investigate the correlation of cavity and OS in patients with NSCLC. RESULTS A total of 364 MW ablation procedures were performed. Adenocarcinoma was the predominant histopathological subtype in patients with cavitary NSCLC (73.7%). Cavitary NSCLC had an incidence rate of 57.9% in overall complications, which was significantly higher than that of 34.6% for noncavitary NSCLC (P = .040). In a mean follow-up of 27.2 months ± 11.9, the median PFS and OS for cavitary NSCLC were 9.0 months ± 8.5 and 14.0 months ± 10.8, respectively, and those for noncavitary NSCLC were 13.0 months ± 10.7 and 17.0 months ± 10.9, respectively. There was no significant difference in PFS (P = .180) or OS (P = .133) between cavitary and noncavitary NSCLC. In addition, the local recurrence rates for cavitary and noncavitary NSCLC were 15.8% and 21.5%, respectively, and no significant difference was found (P = .765). The Kaplan-Meier method revealed no association between the cavity and OS in patients with NSCLC treated with MW ablation. CONCLUSIONS MW ablation was an effective and safe approach for cavitary NSCLC treatment. Compared with noncavitary NSCLC, cavitary NSCLC manifested with more complications but a comparable outcome after MW ablation.
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Affiliation(s)
- Sheng Xu
- Department of 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
| | - Zhi-Xin Bie
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuan-Ming Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Run-Qi Guo
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao-Guang Li
- Department of 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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15
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Xu S, Qi J, Li B, Bie ZX, Li YM, Li XG. Risk prediction of pleural effusion in lung malignancy patients treated with CT-guided percutaneous microwave ablation: a nomogram and artificial neural network model. Int J Hyperthermia 2021; 38:220-228. [PMID: 33593220 DOI: 10.1080/02656736.2021.1885755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To develop an effective nomogram and artificial neural network (ANN) model for predicting pleural effusion after percutaneous microwave ablation (MWA) in lung malignancy (LM) patients. METHODS LM patients treated with MWA were randomly allocated to either the training cohort or the validation cohort (7:3). The predictors of pleural effusion identified by univariable and multivariable analyses in the training cohort were used to develop a nomogram and ANN model. The C-statistic was used to evaluate the predictive accuracy in both the training and validation cohorts. RESULTS A total of 496 patients (training cohort: n = 357; validation cohort: n = 139) were enrolled in this study. The predictors selected into the nomogram for pleural effusion included the maximum power (hazard ratio [HR], 1.060; 95% confidence interval [CI], 1.022-1.100, p = 0.002), the number of pleural punctures (HR, 2.280; 95% CI, 1.103-4.722; p = 0.026) and the minimum distance from needle to pleura (HR, 0.840; 95% CI, 0.775-0.899; p < 0.001). The C-statistic showed good predictive performance in both cohorts, with a C-statistic of 0.866 (95% CI, 0.787-0.945) internally and 0.782 (95% CI, 0.644-0.920) externally (training cohort and validation cohort, respectively). The optimal cutoff value for the risk of pleural effusion was 0.16. CONCLUSIONS Maximum power, number of pleural punctures and minimum distance from needle to pleura were predictors of pleural effusion after MWA in LM patients. The nomogram and ANN model could effectively predict the risk of pleural effusion after MWA. Patients showing a high risk (>0.16) on the nomogram should be monitored for pleural effusion.
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Affiliation(s)
- Sheng Xu
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Qi
- School of Medicine, Nankai University, Tianjin, China
| | - Bin Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Zhi-Xin Bie
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Yuan-Ming Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Xiao-Guang Li
- Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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16
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Zeng C, Lu J, Tian Y, Fu X. Thermal Ablation Versus Wedge Resection for Stage I Non-small Cell Lung Cancer Based on the Eighth Edition of the TNM Classification: A Population Study of the US SEER Database. Front Oncol 2020; 10:571684. [PMID: 33154946 PMCID: PMC7591765 DOI: 10.3389/fonc.2020.571684] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/18/2020] [Indexed: 12/25/2022] Open
Abstract
Background The incidence rates of early-stage non-small cell lung cancer (NSCLC) are now increasing, and therapies such as thermal ablation have shown potential therapeutic promise. This study aimed to determine the influence of different surgical methods on overall survival (OS) and cancer-specific survival (CSS) in patients with stage I NSCLC. Methods Patients diagnosed with stage I NSCLC who had received thermal ablation or wedge resection between 2004 and 2014 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was performed according to the surgical method. Kaplan–Meier curves and a Cox proportional hazard model were used to evaluate OS and CSS. Results In all, 4,372 patients with stage I NSCLC were included. Before PSM, the respective 3- and 5-year OS rates were 68.9 and 52.7% in the wedge resection group and 68.5 and 47.8% in the thermal ablation group (p < 0.0001); the corresponding CSS rates were 79.1 and 69.4% and 62.6 and 46.0% (p < 0.0001). After PSM, survival analysis showed that wedge resection had better OS (44.5% vs. 30.1%, p = 0.033) and CSS (63.5% vs. 46%, p = 0.038) than thermal ablation. After PSM, Cox regression showed that treatment was not associated with OS or CSS. For patients aged >75 years, thermal ablation showed similar OS and CSS as wedge resection (OS: 30.6% vs. 41.7%, p = 0.470; CSS: 46.4% vs. 64.1%, p = 0.100). After PSM, thermal ablation still had OS (30.6% vs. 41.0%, p = 0.470) and CSS (46.4% vs. 59.8%, p = 0.100) comparable to wedge resection. Conclusion For patients with stage I NSCLC who are unfit for lobectomy, thermal ablation could be a potential therapeutic option, especially for those >75 years old.
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Affiliation(s)
- Chenxi Zeng
- Thoracic Surgery Laboratory, Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiawei Lu
- Thoracic Surgery Laboratory, Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yitao Tian
- Thoracic Surgery Laboratory, Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangning Fu
- Thoracic Surgery Laboratory, Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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17
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Ni Y, Xu H, Ye X. Image-guided percutaneous microwave ablation of early-stage non-small cell lung cancer. Asia Pac J Clin Oncol 2020; 16:320-325. [PMID: 32969192 DOI: 10.1111/ajco.13419] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 06/07/2020] [Indexed: 12/24/2022]
Abstract
Although surgical lobectomy with systematic mediastinal lymph node evaluation is considered as the "gold standard" for management of early stage non-small cell lung cancer (NSCLC), image-guided percutaneous thermal ablation has been increasingly used for medically inoperable patients. Radiofrequency ablation (RFA) is a research-based technique that has the most studies for medically inoperable early-stage NSCLC. Other thermal ablation techniques used to treat pulmonary tumors include microwave ablation (MWA), cryoablation and laser ablation. MWA has several advantages over RFA including reduced procedural time, reduced heat-sink effect, large ablation zones, decreased susceptibility to tissue impedance, and simultaneous use of multiple antennae. This review article highlights the most relevant updates of MWA for the treatment of early-stage NSCLC, including mechanism of action, clinical outcomes, potential complications, the existing technique problems and future directions.
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Affiliation(s)
- Yang Ni
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Hui Xu
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Xin Ye
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
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18
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Pritchett MA, Schirmer CC, Laeseke P. Melting the tip of the iceberg: bronchoscopic-guided transbronchial microwave ablation. Transl Lung Cancer Res 2020; 9:960-963. [PMID: 32953475 PMCID: PMC7481599 DOI: 10.21037/tlcr.2020.04.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Michael A Pritchett
- Department of Pulmonary Medicine, FirstHealth of the Carolinas & Pinehurst Medical Clinic, Pinehurst, NC, USA
| | - Charles C Schirmer
- Department of Pathology, FirstHealth of the Carolinas, Pinehurst, NC, USA
| | - Paul Laeseke
- Department of Radiology, University of Wisconsin, Madison, WI, USA
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19
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Zhao H, Steinke K. Long‐term outcome following microwave ablation of early‐stage non‐small cell lung cancer. J Med Imaging Radiat Oncol 2020; 64:787-793. [DOI: 10.1111/1754-9485.13091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/27/2020] [Accepted: 07/04/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Henry Zhao
- Department of Medical Imaging Royal Brisbane and Women’s Hospital Brisbane Queensland Australia
- Faculty of Medicine The University of Queensland St Lucia, Brisbane Queensland Australia
| | - Karin Steinke
- Department of Medical Imaging Royal Brisbane and Women’s Hospital Brisbane Queensland Australia
- Faculty of Medicine The University of Queensland St Lucia, Brisbane Queensland Australia
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20
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Tong ZMD, Wenzhao LMD, Yuanyuan SMD, Zhengmin WMD, Dezhi ZMD. US-CT Fusion Image-Guided Microwave Ablation of Lung Cancer----A New Mode of Image Guidance in Lung Cancer Ablation. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2020. [DOI: 10.37015/audt.2020.190025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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21
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Pusceddu C, Melis L, Sotgia B, Guerzoni D, Porcu A, Fancellu A. Usefulness of percutaneous microwave ablation for large non-small cell lung cancer: A preliminary report. Oncol Lett 2019; 18:659-666. [PMID: 31289539 PMCID: PMC6546981 DOI: 10.3892/ol.2019.10375] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 05/13/2019] [Indexed: 02/06/2023] Open
Abstract
The role of microwave ablation (MWA) in patients with non-small cell lung cancer (NSCLC) remains ill-defined. This retrospective study evaluated the oncological outcomes of CT-guided MWA in patients with large NSCLC. Kaplan-Meier analysis was used to evaluate overall survival (OS) and cancer-specific survival (CSS). The log-rank test was used to compare survival between patients with an NSCLC size greater or smaller than 4 cm. The likelihood of local tumor progression (LTP) was analyzed using a multivariable regression model. A total of 53 patients with 65 tumors were analyzed. The mean tumor size was 5.0±1.8 cm. At the 1-month CT scan, complete tumor ablation was observed in 44.6% of cases. In 18.5% of cases a redo-MWA session was carried out, while in 4.6%, a third MWA was necessary to obtain complete tumor necrosis. The mean follow-up was 28.1±20.6 months with a median duration of 21.5 months. The 1-year, 2-year, 3-year and 5-year OS rates were 78.2, 48.3, 34.8 and 18.3%, respectively. The median CSS was 25 months (95% CI 15.5–34.5). The 1-year, 2-year, 3-year and 5-year CSS rates were 84.3, 53.7, 42.1 and 30.0%, respectively. OS in patients with tumor size ≥4 cm was significantly lower when compared with those having smaller tumors (P=0.03). LTP was observed in 19 patients (35.8%). Incomplete tumor ablation [odds ratio (OR) 6.57; P<0.05] and tumor size ≥4 cm (OR 0.18; P<0.05) were significant independent predictors of LTP. In conclusion, CT-guided MWA may represent a useful tool in the multimodality treatment of patients with large advanced NSCLC.
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Affiliation(s)
- Claudio Pusceddu
- Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital A. Businco, I-09121 Cagliari, Italy
| | - Luca Melis
- Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital A. Businco, I-09121 Cagliari, Italy
| | - Barbara Sotgia
- Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital A. Businco, I-09121 Cagliari, Italy
| | - Daniela Guerzoni
- Department of Medical Oncology, Oncological Hospital A. Businco, I-09121 Cagliari, Italy
| | - Alberto Porcu
- Department of Clinical, Surgical and Experimental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, I-07100 Sassari, Italy
| | - Alessandro Fancellu
- Department of Clinical, Surgical and Experimental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, I-07100 Sassari, Italy
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22
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Temporal evaluation of the microwave ablation zone and comparison of CT and gross sizes during the first month post-ablation in swine lung. Diagn Interv Imaging 2019; 100:279-285. [DOI: 10.1016/j.diii.2018.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 12/22/2022]
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Abstract
Current advances in guided bronchoscopy methods permit minimally invasive access to essentially any area of the lungs. This provides a potential means to treat patients with localized lung malignancies who might not otherwise tolerate conventional treatment, which commonly relies on surgical resection. Ablation methods have long been used for bronchoscopic treatment of central airway malignancies and percutaneous treatment of peripheral lung cancer. This article reviews ablation technologies being adapted for use with guided bronchoscopy and the current state of investigation for the treatment of peripheral lung malignancies.
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Affiliation(s)
- David W Hsia
- Division of Respiratory and Critical Care Physiology and Medicine, Harbor-UCLA Medical Center, 1000 West Carson Street, Box #402, Torrance, CA 90502, USA.
| | - Ali I Musani
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine and University Hospital, 12631 East 17th Avenue, M/S C323, Office #8102, Aurora, CO 80045, USA
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Local Thermal Ablation with Continuous EGFR Tyrosine Kinase Inhibitors for EGFR-Mutant Non-small Cell Lung Cancers that Developed Extra-Central Nervous System (CNS) Oligoprogressive Disease. Cardiovasc Intervent Radiol 2019; 42:693-699. [PMID: 30701290 DOI: 10.1007/s00270-018-02153-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/21/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Most epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients treated with tyrosine kinase inhibitors (TKIs) experience oligoprogressive disease. Local ablation for isolated resistant sites continued with the original EGFR-TKI showed good efficacy in these patients. We conducted this multicenter retrospective study to investigate the potential benefit of thermal ablation in NSCLC patients that developed extra-central nervous system (CNS) oligoprogressive disease during TKI treatment. METHODS A total of 71 EGFR-mutant patients treated with EGFR-TKIs were identified. Progression-free survival 1 (PFS1) was calculated from the initiation of TKI treatment to first progression. Patients with metastatic sites ≤ 3 in less than 3 extra-CNS organs suitable for local ablation therapy received either radiofrequency ablation or microwave ablation to these sites and continued on the original TKIs. PFS2 was defined from the first progression to second progression after ablation. RESULTS The median PFS1 for all patients was 11.8 months. Eighty extra-CNS oligoprogressive lesions in 71 patients were ablated. Thirty-six of 71 patients progressed after thermal ablation and 31 of whom died during the study period. The median PFS2 after thermal ablation was 10.0 months, and the median overall survival was 26.4 months. PFS1 and PFS2 were highly correlated with OS, whereas PFS1 was not correlated with PFS2. The numbers of oligoprogressive lesions were significantly and independently associated with PFS2. CONCLUSION Local thermal ablation for the oligoprogressive lesions with continuous EGFR-TKI treatment is associated with additional 10 months of disease control and should be recommended in TKI acquired resistant-NSCLC patients.
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Kodama H, Ueshima E, Gao S, Monette S, Paluch LR, Howk K, Erinjeri JP, Solomon SB, Srimathveeravalli G. High power microwave ablation of normal swine lung: impact of duration of energy delivery on adverse event and heat sink effects. Int J Hyperthermia 2018; 34:1186-1193. [PMID: 29490524 DOI: 10.1080/02656736.2018.1447149] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE The purpose of this study is to assess the impact of duration of energy delivery on adverse events (AEs) and heat sink effects during high power microwave ablation (MWA) of normal swine lung. MATERIALS AND METHODS High power (100 W) MWA was performed with short (2 min, 18 ablations) or long (10 min, nine ablations) duration of energy delivery in unilateral lung of swine (n = 10). CT imaging was done prior to sacrifice at 2 or 28 d post-treatment, with additional imaging at 7 and 14 d for the latter cohort. Ablation zones were assessed with CT imaging and histopathology analysis. Differences in AEs and ablation characteristics between groups were compared with Fisher's exact test and Student's t-test, respectively. RESULTS There were no significant differences in formation of air-filled needle tract, cavitation, and pneumonia (p > 0.5) between the treatment groups. Intra-procedural pneumothorax requiring chest tube placement occurred in three animals. Substantial (>20%, p = 0.01) intra-procedural ablation zone distortion was observed in both groups. The presence of large airways or blood vessels did not result in heat sink effect within the ablation zones and was not indicative of reduced ablation size. Increased energy delivery yielded larger (8.9 ± 3.1 cm3 vs. 3.4 ± 1.7 cm3, p < 0.001) spherical ablations (sphericity: 0.70 ± 0.10 vs. 0.56 ± 0.13, p = 0.01). CONCLUSIONS High power MWA of normal lung with longer duration of energy delivery can create larger spherical ablations, without significant differences in post-procedure AEs when compared with shorter energy delivery time.
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Affiliation(s)
- Hiroshi Kodama
- a Department of Radiology , Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Eisuke Ueshima
- a Department of Radiology , Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Song Gao
- a Department of Radiology , Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Sebastien Monette
- b Laboratory of Comparative Pathology , Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine , New York , NY , USA
| | - Lee-Ronn Paluch
- c Center of Comparative Medicine and Pathology , Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, Hospital for Special Surgery , New York , NY , USA
| | - Kreg Howk
- d Medtronic Inc , Massachusetts , MA , USA
| | - Joseph P Erinjeri
- a Department of Radiology , Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center , New York , NY , USA.,e Department of Radiology , Weill Cornell Medical College , New York , NY , USA
| | - Stephen B Solomon
- a Department of Radiology , Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center , New York , NY , USA.,e Department of Radiology , Weill Cornell Medical College , New York , NY , USA
| | - Govindarajan Srimathveeravalli
- a Department of Radiology , Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center , New York , NY , USA.,d Medtronic Inc , Massachusetts , MA , USA
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Zhao Q, Tian G, Chen F, Zhong L, Jiang T. CT-guided percutaneous laser ablation of metastatic lung cancer: three cases report and literature review. Oncotarget 2018; 8:2187-2196. [PMID: 27974695 PMCID: PMC5356791 DOI: 10.18632/oncotarget.13901] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/22/2016] [Indexed: 01/06/2023] Open
Abstract
Objective To report the efficacy and safety of CT-guided percutaneous laser ablation (PLA) for metastatic lung tumors. Methods Three cases of metastatic lung cancer underwent CT-guided PLA, and we searched for previously published articles on the minimally invasive CT-guided RFA or MWA for lung tumors in recent five years. Results With the guidance of CT, all lesions had good prognosis under laser ablation. Case 1 suffering from severe pulmonary dysfunction and diffuse pulmonary bullae, had small pneumothorax. CT scan obtained four months following the ablation showed two lesions had complete responses and one partial response. Case 2 had successful complete response with absent lung mass, and also had a good postoperative condition without any discomfort in the two-month follow-up. Case 3 showed partial response and improved greatly after five months. 962 cases (mean age of 45.7 years, 62.2% male) of 1297 lung tumors with detailed information were identified from 27 articles. Of these cases, the minority manifested complications such as pneumothorax, hemoptysis, hemothorax, pneumonia, pain and fever. Conclusions Percutaneous CT-guided PLA could be a safe and promising minimally invasive treatment for patients with primary lung cancer or unresectable pulmonary metastases, especially multineedle PLA in large tumors, which still needs more large-scale prospective studies to convince this method in the future.
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Affiliation(s)
- Qiyu Zhao
- Department of Ultrasonography, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guo Tian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fen Chen
- Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Liyun Zhong
- Department of Ultrasonography, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tian'an Jiang
- Department of Ultrasonography, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Jiang B, Mcclure MA, Chen T, Chen S. Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis. Ann Thorac Med 2018; 13:243-250. [PMID: 30416597 PMCID: PMC6196668 DOI: 10.4103/atm.atm_392_17] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE: The objective of this study was to compare the efficacy and safety of radiofrequency ablation (RFA), cryoablation, and microwave ablation (MWA) for patients with lung malignancies. METHODS: We performed a network meta-analysis to identify both direct and indirect evidence from relevant trials by searching PubMed, Embase, and the Cochrane Library to December 31, 2017, for the treatment of malignant lung tumors with the use of RFA, MWA, or cryoablation. We extracted the relevant information from the published studies with a predefined data sheet and assessed the risk of bias with the Cochrane risk of bias tool. The primary outcomes were efficacy (local progression rate and overall survival rate) and safety (major complications rate). We did a random-effects network meta-analysis within a Bayesian framework as well as assessed the quality of evidence contributing to each network estimate using GRADE framework. RESULTS: We collected 34 studies eligible which included 1840 participants and 2520 lung malignancies (1318 primary lung cancer and 1202 pulmonary metastatic tumors). The quality of evidence was rated as very low in most comparisons. From the point of local progression rate, RFA and MWA were significantly more effective than cryoablation with odds ratio (OR) of 0.04 (95% confidence interval [CI]: 0.004, 0.38; P = 0.005) and 0.02 (95% CI: 0.002, 0.24; P = 0.001), respectively. No significant difference was found between MWA and RFA with an OR of 0.63 (95% CI: 0.04, 10.39; P = 0.745). Regarding the major complications, RFA, MWA, and cryoablation showed the comparable safety (P > 0.05). CONCLUSION: RFA and MWA offer an advantage over cryoablation for patients with malignant lung tumors.
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Affiliation(s)
- Binghu Jiang
- Department of Radiology and Imaging Institute of Rehabilitation and Development of Brain Function, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China.,Department of Thoracic Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Morgan A Mcclure
- Department of Radiology and Imaging Institute of Rehabilitation and Development of Brain Function, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
| | - Tianming Chen
- Department of Thoracic Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Shilin Chen
- Department of Thoracic Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
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Cheng G, Shi L, Qiang W, Wu J, Ji M, Lu Q, Li X, Xu B, Jiang J, Wu C. The safety and efficacy of microwave ablation for the treatment of CRC pulmonary metastases. Int J Hyperthermia 2017; 34:486-491. [PMID: 28847194 DOI: 10.1080/02656736.2017.1366553] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Microwave ablation (MWA) is a recently developed thermal ablation technique that has been used for the treatment of different types of tumours. In the present study, we retrospectively evaluated the safety and efficacy of CT-guided percutaneous MWA for the treatment of colorectal cancer (CRC) pulmonary metastases. MATERIALS AND METHODS From June 2010 to June 2015, 48 unresectable lesions in 32 patients with CRC pulmonary metastases were subjected to CT-guided MWA. Imaging follow-up was with contrast-enhanced CT and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT. RESULTS Oncologic imaging showed that 42 (87.5%) of the 48 lesions in the 32 patients were completely ablated. Needle track metastatic seeding was not found, and no patient deaths occurred within 30 d after ablation. The mean hospital stay was 3 d (range, 2-7 d). Pneumothorax was the most frequent complication and occurred in 6 (12.5%) of the 48 lesions. The median survival time was 31 months (95% CI: 15.4-46.6). The 1-, 2- and 3-year survival rates were 79.5%, 63.1% and 44.4%, respectively. Univariate Cox regression analysis showed that tumour size, disease-free interval (DFI) and number of tumours were significantly related to the overall survival time (p = .007, p = .022 and p = .030, respectively). Multivariate analysis showed that tumour size was an independent prognostic factor for survival (p = .017). CONCLUSION CT-guided percutaneous MWA is a safe and effective minimally invasive method for treating CRC pulmonary metastases.
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Affiliation(s)
- Gui Cheng
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Liangrong Shi
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Weiguang Qiang
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Jun Wu
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Mei Ji
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Qicheng Lu
- b Department of Gastrointestinal Surgery , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Xiaodong Li
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Bin Xu
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Jingting Jiang
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
| | - Changping Wu
- a Department of Tumor Biological Treatment , The Third Affiliated Hospital, Soochow University , Changzhou , PR China
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Shi F, Li G, Zhou Z, Xu R, Li W, Zhuang W, Chen Z, Chen X. Microwave ablation versus radiofrequency ablation for the treatment of pulmonary tumors. Oncotarget 2017; 8:109791-109798. [PMID: 29312649 PMCID: PMC5752562 DOI: 10.18632/oncotarget.22308] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/17/2017] [Indexed: 01/16/2023] Open
Abstract
To retrospectively compare the efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) in the treatment of pulmonary tumors, a total of 75 patients with lung tumor who underwent thermal ablation therapy in Guangdong General Hospital into the study from March 2007 to December 2014 were enrolled. Of the patients, 43 received radiofrequency ablation and 32 received microwaves ablation. The response rates, overall survival (OS), and complications rates between the RFA group and MWA group were compared. There were no significant differences in the baseline characteristics between two groups. The overall response rates of in RFA and MWA groups were 79% (34/43) and 69% (22/32), respectively, and there was no statistically significant difference between two groups (P = 0.309). The 1-, 2-, 3-, 5-year overall survival (OS) rates in RFA group and MWA group were 77%, 55%, 42%, 34% and 75%, 44%, 40%, 27%, respectively. No significant differences were found in the OS rates between two groups (P = 0.653). The complication rates were 49% (21/43) in RFA group and 50% (16/32) in MWA group; there was no significant difference between two groups (P = 0.921). No patients died during the perioperative period. Our study shows that no significant differences exist in efficacy and safety between RFA and MWA for the treatment of pulmonary tumors, which indicates that MWA could be a substitute therapy for RFA in terms of effectiveness and safety for treating pulmonary tumors.
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Affiliation(s)
- Feng Shi
- Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
| | - Guangxiao Li
- Department of Tumor Internal Medicine, Hexian Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Zejian Zhou
- Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
| | - Rongde Xu
- Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
| | - Weike Li
- Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
| | - Wenhang Zhuang
- Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
| | - Zide Chen
- Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
| | - Xiaoming Chen
- Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
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Narsule CK, Sridhar P, Nair D, Gupta A, Oommen RG, Ebright MI, Litle VR, Fernando HC. Percutaneous thermal ablation for stage IA non-small cell lung cancer: long-term follow-up. J Thorac Dis 2017; 9:4039-4045. [PMID: 29268414 DOI: 10.21037/jtd.2017.08.142] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Surgical resection is the most effective curative therapy for non-small cell lung cancer (NSCLC). However, many patients are unable to tolerate resection secondary to poor reserve or comorbid disease. Radiofrequency ablation (RFA) and microwave ablation (MWA) are methods of percutaneous thermal ablation that can be used to treat medically inoperable patients with NSCLC. We present long-term outcomes following thermal ablation of stage IA NSCLC from a single center. Methods Patients with stage IA NSCLC and factors precluding resection who underwent RFA or MWA from July 2005 to September 2009 were studied. CT and PET-CT scans were performed at 3 and 6 month intervals, respectively, for first 24 months of follow-up. Factors associated with local progression (LP) and overall survival (OS) were analyzed. Results Twenty-one patients underwent 21 RFA and 4 MWA for a total of 25 ablations. Fifteen patients had T1a and six patients had T1b tumors. Mean follow-up was 42 months, median survival was 39 months, and OS at three years was 52%. There was no significant difference in median survival between T1a nodules and T1b nodules (36 vs. 39 months, P=0.29) or for RFA and MWA (36 vs. 50 months, P=0.80). Ten patients had LP (47.6%), at a median time of 35 months. There was no significant difference in LP between T1a and T1b tumors (22 vs. 35 months, P=0.94) or RFA and MWA (35 vs. 17 months, P=0.18). Median OS with LP was 32 months compared to 39 months without LP (P=0.68). Three patients underwent repeat ablations. Mean time to LP following repeat ablation was 14.75 months. One patient had two repeat ablations and was disease free at 40-month follow-up. Conclusions Thermal ablation effectively treated or controlled stage IA NSCLC in medically inoperable patients. Three-year OS exceeded 50%, and LP did not affect OS. Therefore, thermal ablation is a viable option for medically inoperable patients with early stage NSCLC.
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Affiliation(s)
- Chaitan K Narsule
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Praveen Sridhar
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Divya Nair
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Avneesh Gupta
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Roy G Oommen
- Department of Surgery, Columbia University, NewYork-Presbytarian/Lawrence Hospital Center, Bronxville, NY, USA
| | - Michael I Ebright
- Section of Thoracic Surgery, Columbia University Medical Center, New York, NY, USA
| | - Virginia R Litle
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Hiran C Fernando
- Division of Thoracic Surgery, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA, USA
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Klapper JA, Hittinger SA, Denlinger CE. Alternatives to Lobectomy for High-Risk Patients With Early-Stage Non-Small Cell Lung Cancer. Ann Thorac Surg 2017; 103:1330-1339. [DOI: 10.1016/j.athoracsur.2016.11.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 12/25/2022]
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Microwave Ablation for Lung Neoplasms: A Retrospective Analysis of Long-Term Results. J Vasc Interv Radiol 2017; 28:206-211. [DOI: 10.1016/j.jvir.2016.10.030] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 11/23/2022] Open
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The Role of Interventional Oncology in the Management of Lung Cancer. Cardiovasc Intervent Radiol 2016; 40:153-165. [PMID: 27815575 DOI: 10.1007/s00270-016-1495-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 10/26/2016] [Indexed: 12/11/2022]
Abstract
Interventional radiological procedures for diagnosis and treatment of lung cancer have become increasingly important. Imaging-guided percutaneous biopsy has become the modality of choice for diagnosing lung cancer, and in the era of target therapies, it is an useful tool to define earlier patient-specific tumor phenotypes. In functionally inoperable patients, especially the ablative procedures are potentially curative alternatives to surgery. In addition to thermally ablative treatment, selective chemoembolization by a vascular access allows localized therapy. These treatments are considered for patients in a reduced general condition which does not allow systemic chemotherapy. The present article reviews the role of interventional oncology in the management of primary lung cancer, focusing on the state of the art for each procedure.
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Zheng A, Ye X, Yang X, Huang G, Gai Y. Local Efficacy and Survival after Microwave Ablation of Lung Tumors: A Retrospective Study in 183 Patients. J Vasc Interv Radiol 2016; 27:1806-1814. [PMID: 27789077 DOI: 10.1016/j.jvir.2016.08.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 08/21/2016] [Accepted: 08/22/2016] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To retrospectively evaluate local efficacy and survival after microwave (MW) ablation of lung tumors and identify predictors of prognosis. MATERIALS AND METHODS Data from 183 consecutive patients (67 women; mean age, 61.5 y ± 13.4) with lung tumors who had undergone 203 lung MW ablation sessions from January 2011 to May 2013 were assessed. The χ2 test, independent-samples t test, Kaplan-Meier analysis, and Cox regression model analysis were used to estimate survival rates and evaluate significance of factors affecting rates of incomplete ablation, local progression, remote progression-free survival (RPFS), and cancer-specific survival (CSS). RESULTS Technical success rate was 100%. Incomplete ablation rate after 183 first MW ablations was 14.2% (26 of 183); maximum diameter of target tumors (P = .00001) was associated with incomplete ablation on univariate analysis. The local progression rate was 19.1% (35 of 183); emphysema (P = .020) and maximum diameter of target tumor (P = .000003) were associated with local progression. Median and 4-year RPFS were 15.0 months (95% confidence interval [CI], 11.1-18.9 mo) and 23.8%, respectively. Tumor stage (P < .01) and incomplete ablation (P = .002) were independent predictors of RPFS. Median and 4-year CSS were 24.9 months (95% CI, 19.9-29.9 mo) and 31.1%, respectively. Median and 4-year overall survival were 23.7 months (95% CI, 20.6-26.8 mo) and 29.6%, respectively. Tumor stage (P < .01) and maximum diameter (P = .009) were independent risk factors for CSS. CONCLUSIONS MW ablation is effective for lung tumors, especially small lesions of early-stage primary lung cancer and solitary lung metastasis.
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Affiliation(s)
- Aimin Zheng
- Departments of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Rd., Jinan 250021, China.
| | - Xin Ye
- Departments of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Rd., Jinan 250021, China
| | - Xia Yang
- Departments of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Rd., Jinan 250021, China
| | - Guanghui Huang
- Departments of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Rd., Jinan 250021, China
| | - Yonghao Gai
- Radiology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Rd., Jinan 250021, China
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Wei Z, Ye X, Yang X, Huang G, Li W, Wang J, Han X, Meng M, Ni Y. Advanced non small cell lung cancer: response to microwave ablation and EGFR Status. Eur Radiol 2016; 27:1685-1694. [PMID: 27436020 DOI: 10.1007/s00330-016-4474-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 05/12/2016] [Accepted: 06/16/2016] [Indexed: 12/22/2022]
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Ni X, Han JQ, Ye X, Wei ZG. Percutaneous CT-guided microwave ablation as maintenance after first-line treatment for patients with advanced NSCLC. Onco Targets Ther 2015; 8:3227-35. [PMID: 26604789 PMCID: PMC4640441 DOI: 10.2147/ott.s90528] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Systemic therapy is recommended for advanced non-small-cell lung cancer (NSCLC). However, conventional first-line treatment has generated a plateau in response rate of 25% to 35%. Few studies have shown patients benefit from microwave ablation (MWA) in combination with radiotherapy and chemotherapy. This study aims to evaluate safety and efficacy of percutaneous computed tomography-guided MWA as maintenance after first-line treatment for patients with advanced NSCLC. METHODS Patients with histologically verified NSCLC stage IIIB or IV between January 2010 and March 2014 were involved. After completion of first-line treatment with partial response or stable disease, 35 patients with 39 tumors underwent 39 MWA procedures. Complications, progression-free survival (PFS), overall survival (OS), and correlated predictors were analyzed. RESULTS During a median follow-up of 17.7 months and 10.8 months after initial MWA, local efficacy was 87.2%, median MWA-related local control time was 10.6 months, and tumor size was the only predictor (P=0.002). Median MWA-related PFS, MWA-related OS, PFS, and OS were 5.4, 10.6, 11.8 and 17.7 months, respectively. Local efficacy was significantly correlated with MWA-related PFS (P=0.003), MWA-related OS (P=0.000), and OS (P=0.001). There were no procedure-specific deaths. Total incidence of major complications was 12.8%, including pneumothorax resolved by closed pleural drainage and pneumonia controlled by antibiotics in a short time. CONCLUSION This study concluded two points, including: 1) patients benefited from MWA as maintenance both in local control and survival; 2) as maintenance MWA was superior to conventional maintenance therapy with improved survival and well-tolerated complications. Therefore, MWA was a safe and effective maintenance after first-line treatment in patients with advanced NSCLC.
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Affiliation(s)
- Xiang Ni
- Department of Oncology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, People’s Republic of China
| | - Jun-Qing Han
- Department of Oncology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, People’s Republic of China
| | - Xin Ye
- Department of Oncology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, People’s Republic of China
| | - Zhi-Gang Wei
- Department of Oncology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, People’s Republic of China
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Retention Rate of Electromagnetic Navigation Bronchoscopic Placed Fiducial Markers for Lung Radiosurgery. Ann Thorac Surg 2015; 100:1163-5; discussion 1165-6. [DOI: 10.1016/j.athoracsur.2015.04.060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 03/31/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
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Xu X, Ye X, Liu G, Zhang T. Targeted percutaneous microwave ablation at the pulmonary lesion combined with mediastinal radiotherapy with or without concurrent chemotherapy in locally advanced non-small cell lung cancer evaluation in a randomized comparison study. Med Oncol 2015; 32:227. [PMID: 26243048 DOI: 10.1007/s12032-015-0672-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 07/23/2015] [Indexed: 12/22/2022]
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Lee KS, Takaki H, Yarmohammadi H, Srimathveeravalli G, Luchins K, Monette S, Nair S, Kishore S, Erinjeri JP. Pleural puncture that excludes the ablation zone decreases the risk of pneumothorax after percutaneous microwave ablation in porcine lung. J Vasc Interv Radiol 2015; 26:1052-8. [PMID: 25753501 DOI: 10.1016/j.jvir.2015.01.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 01/11/2015] [Accepted: 01/12/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To test the hypothesis that the geometry of probe placement with respect to the pleural puncture site affects the risk of pneumothorax after microwave (MW) ablation in the lung. MATERIALS AND METHODS Computed tomography-guided MW ablation of the lung was performed in 8 swine under general anesthesia and mechanical ventilation. The orientation of the 17-gauge probe was either perpendicular (90°) or parallel (< 30°) with respect to the pleural puncture site, and the ablation power was 30 W or 65 W for 5 minutes. After MW ablation, swine were euthanized, and histopathologic changes were assessed. Frequency and factors affecting pneumothorax were evaluated by multivariate analysis. RESULTS Among 62 lung MW ablations, 13 (21%) pneumothoraces occurred. No statistically significant difference was noted in the rate of pneumothorax between the perpendicular and the parallel orientations of the probe (31% vs 14%; odds ratio [OR], 2.8; P = .11). The pneumothorax rate was equal for 65-W and 30-W ablation powers (21% and 21%; OR, 1.0; P = .94). Under multivariate analysis, 2 factors were independent positive predictors of pneumothorax: ablation zone inclusive of pleural insertion point (OR, 7.7; P = .02) and time since intubation (hours) (OR, 2.7; P = .02). CONCLUSIONS Geometries where the pleural puncture site excluded the ablation zone decreased pneumothorax in swine undergoing MW ablation in the lung. Treatment planning to ensure that the pleural puncture site excludes the subsequent ablation zone may reduce the rate of pneumothorax in patients undergoing MW ablation in the lung.
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Affiliation(s)
- Kyungmouk Steve Lee
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065
| | - Haruyuki Takaki
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065
| | - Hooman Yarmohammadi
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065
| | | | - Kerith Luchins
- Research Animal Resource Center Memorial, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065
| | - Sébastien Monette
- Laboratory of Comparative Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065
| | - Sreejit Nair
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065
| | - Sirish Kishore
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065
| | - Joseph P Erinjeri
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065..
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Microwave ablation plus chemotherapy improved progression-free survival of advanced non-small cell lung cancer compared to chemotherapy alone. Med Oncol 2015; 32:464. [PMID: 25572816 DOI: 10.1007/s12032-014-0464-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 12/16/2014] [Indexed: 01/13/2023]
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Acksteiner C, Steinke K. Percutaneous microwave ablation for early-stage non-small cell lung cancer (NSCLC) in the elderly: A promising outlook. J Med Imaging Radiat Oncol 2014; 59:82-90. [DOI: 10.1111/1754-9485.12251] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 09/02/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | - Karin Steinke
- Department of Medical Imaging; Royal Brisbane and Women's Hospital; University of Queensland School of Medicine; Brisbane Queensland Australia
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Ridge CA, Solomon SB, Thornton RH. Thermal ablation of stage I non-small cell lung carcinoma. Semin Intervent Radiol 2014; 31:118-24. [PMID: 25053863 DOI: 10.1055/s-0034-1373786] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ablation options for the treatment of localized non-small cell lung carcinoma (NSCLC) include radiofrequency ablation, microwave ablation, and cryotherapy. Irreversible electroporation is a novel ablation method with the potential of application to lung tumors in risky locations. This review article describes the established and novel ablation techniques used in the treatment of localized NSCLC, including mechanism of action, indications, potential complications, clinical outcomes, postablation surveillance, and use in combination with other therapies.
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Affiliation(s)
- Carol A Ridge
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Stephen B Solomon
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Raymond H Thornton
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
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Ridge CA, Silk M, Petre EN, Erinjeri JP, Alago W, Downey RJ, Sofocleous CT, Thornton RH, Solomon SB. Radiofrequency Ablation of T1 Lung Carcinoma: Comparison of Outcomes for First Primary, Metachronous, and Synchronous Lung Tumors. J Vasc Interv Radiol 2014; 25:989-96. [DOI: 10.1016/j.jvir.2014.02.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 12/28/2022] Open
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Petre EN, Solomon SB, Sofocleous CT. The role of percutaneous image-guided ablation for lung tumors. Radiol Med 2014; 119:541-8. [DOI: 10.1007/s11547-014-0427-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 06/11/2014] [Indexed: 12/25/2022]
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46
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Yang X, Ye X, Zheng A, Huang G, Ni X, Wang J, Han X, Li W, Wei Z. Percutaneous microwave ablation of stage I medically inoperable non-small cell lung cancer: clinical evaluation of 47 cases. J Surg Oncol 2014; 110:758-63. [PMID: 24965604 DOI: 10.1002/jso.23701] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 05/07/2014] [Indexed: 12/13/2022]
Abstract
PURPOSE To retrospectively evaluate safety and effectiveness of CT-guided percutaneous microwave ablation (MWA) in 47 patients with medically inoperable stage I peripheral non-small cell lung cancer (NSCLC). METHODS From February 2008 to October 2012, 47 patients with stage I medically inoperable NSCLC were treated in 47 MWA sessions. The clinical outcomes were evaluated. Complications after MWA were also summarized. RESULTS At a median follow-up period of 30 months, the median time to the first recurrence was 45.5 months. The local control rates at 1, 3, 5 years after MWA were 96%, 64%, and 48%, respectively. The median cancer-specific and median overall survivals were 47.4 and 33.8 months. The overall survival rates at 1, 2, 3, and 5 years after MWA were 89%, 63%, 43%, and 16%, respectively. Tumors ≤3.5 cm were associated with better survival than were tumors >3.5 cm. The complications after MWA included pneumothorax (63.8%), hemoptysis (31.9%), pleural effusion (34%), pulmonary infection (14.9%), and bronchopleural fistula (2.1%). CONCLUSIONS MWA is safe and effective for the treatment of medically inoperable stage I peripheral NSCLC.
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Affiliation(s)
- Xia Yang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
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Lee WK, Lau EWF, Chin K, Sedlaczek O, Steinke K. Modern diagnostic and therapeutic interventional radiology in lung cancer. J Thorac Dis 2014; 5 Suppl 5:S511-23. [PMID: 24163744 DOI: 10.3978/j.issn.2072-1439.2013.07.27] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 07/16/2013] [Indexed: 12/13/2022]
Abstract
Imaging has an important role in the multidisciplinary management of primary lung cancer. This article reviews the current state-of-the-art imaging modalities used for the evaluation, staging and post-treatment follow-up and surveillance of lung cancers, and image-guided percutaneous techniques for biopsy to confirm the diagnosis and for local therapy in non-surgical candidates.
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Affiliation(s)
- Wai-Kit Lee
- Department of Medical Imaging, St. Vincent's Hospital, University of Melbourne, Fitzroy, Victoria, Australia
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Yap M, Vinod S, Delaney G. Minimally invasive techniques for medically inoperable stage 1 non small cell lung cancer: radiotherapy is still the gold standard. J Med Imaging Radiat Oncol 2014; 58:134. [PMID: 24529066 DOI: 10.1111/1754-9485.12133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ml Yap
- Liverpool and Macarthur Cancer Therapy Centres, Liverpool, New South Wales, Australia; Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia; University of New South Wales, Kensington, New South Wales, Australia; University of Western Sydney, Campbelltown, New South Wales, Australia
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Steinke K, Liu H. Minimally invasive techniques for medically inoperable stage I non-small cell lung cancer (NSCLC) - image-guided microwave ablation, a promising therapy option. J Med Imaging Radiat Oncol 2014; 58:79-80. [DOI: 10.1111/1754-9485.12149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Karin Steinke
- Department of Medical Imaging; Royal Brisbane and Women's Hospital; Brisbane Australia
| | - Howard Liu
- Radiation Oncology; The Townsville Hospital; Townsville QLD Australia
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50
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Lee KS, Pua BB. Alternative to surgery in early stage NSCLC-interventional radiologic approaches. Transl Lung Cancer Res 2013; 2:340-53. [PMID: 25806253 DOI: 10.3978/j.issn.2218-6751.2013.10.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 09/24/2013] [Indexed: 12/22/2022]
Abstract
Interventional radiologists have a variety of techniques in their armamentarium to treat pulmonary tumors. While most therapies are targeted to metastasis or palliation, percutaneous thermal ablation represents a potential therapy for not only palliation, but to treat inoperable early stage disease. Although radiofrequency ablation (RFA) is the most studied of these ablative techniques, newer technologies of thermal ablation, such as microwave and cryoablation have emerged as additional options. In this article, we will review the three different thermal ablative modalities, including patient selection, technique, outcomes, complications, and imaging follow-up. A brief discussion of state of the art techniques such as irreversible electroporation (IRE) and catheter directed therapies will also be included.
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Affiliation(s)
- Kyungmouk Steve Lee
- Division of Interventional Radiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Bradley B Pua
- Division of Interventional Radiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY 10065, USA
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