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Yang Z, Lyu X, Yang H, Wang B, Xu D, Huo L, Zhang R, Huang Y, Diao B. Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis. Front Immunol 2023; 14:1240149. [PMID: 37869011 PMCID: PMC10587578 DOI: 10.3389/fimmu.2023.1240149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Background Radiofrequency ablation (RFA) and chemotherapy are used to treat lung cancer or pulmonary metastases, but no direct comparison of overall survival (OS) has been published. The present study aimed to assess the OS of RFA and/or chemotherapy in patients with lung cancer or pulmonary metastases who were not candidates for surgical resection. Methods To identify relevant studies, the following databases were electronically searched from their inception to 31 March 2023: PubMed, Embase, Web of Science, Cochrane Library, Scopus, Ovid, ScienceDirect, SinoMed, China National Knowledge Infrastructure Database, Chongqing VIP Chinese Science and Technology Periodical Database, Wanfang Database, LILACS, ClinicalTrials.gov, and Chictr.org. Manual retrieval was also conducted. We used published hazard ratios (HRs) if available or estimates from other survival data. Results A total of 1,387 participants from 14 trials were included in the final analysis. Patients treated with RFA combined with chemotherapy significantly improved OS compared with those treated with chemotherapy alone [HR 0.50, 95% confidence interval (CI) 0.41-0.61; p < 0.00001], with an absolute difference at 12 months of 29.6% (95% CI 23.7-35.5), at 24 months of 19.2% (95% CI 10.1-28.2), and at 36 months of 22.9% (95% CI 12.0-33.7). No statistically significant difference was observed in the subgroups of case type, cancer type, chemotherapy drugs, and tumor size. The HR for OS with RFA plus chemotherapy vs. RFA alone was 0.53 (95% CI 0.41-0.70; p < 0.00001), corresponding to a 27.1% (95% CI 18.3-35.8), 31.0% (95% CI 19.9-41.9), and 24.9% (95% CI 15.0-34.7) absolute difference in survival at 12 months, 24 months, and 36 months, respectively. Subgroup analysis by geographic region and TNM stage showed that RFA combined with chemotherapy still significantly improved OS compared to RFA. The HR of RFA vs. chemotherapy was 0.98 (95% CI 0.60-1.60; p = 0.94), with an absolute difference at 12 months of 1.4% (95% CI -19.2 to 22.1), at 24 months of 7.8% (95% CI -11.3 to 26.8), and at 36 months of 0.3% (95% CI -13.2 to 13.8). The overall indirect comparison of OS for RFA vs. chemotherapy was 0.95 (95% CI 0.72-1.26; p = 0.74). Data on progression-free survival were not sufficiently reported. Conclusion RFA combined with chemotherapy might be a better treatment option for patients with lung cancer or pulmonary metastases than chemotherapy alone or RFA alone. The comparison between RFA and/or chemotherapy remains to be specifically tested. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=335032, identifier CRD42022335032.
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Affiliation(s)
- Ziyi Yang
- Chengdu Seventh People’s Hospital & Chengdu Tumor Hospital, Chengdu, Sichuan, China
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Liu R, Shen Q, Lu H. The efficacy and safety of thermal ablation for patients with lung malignancy: a meta-analysis of 12 studies in China. J Cardiothorac Surg 2022; 17:334. [PMID: 36550584 PMCID: PMC9784073 DOI: 10.1186/s13019-022-02090-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thermal ablation has been increasingly used in the treatment of lung cancer in recent years. This meta-analysis aims to investigate the therapeutic effect and safety of thermal ablation plus chemotherapy as compared with chemotherapy alone in treating patients with lung malignancy in China based on current evidence. METHODS Databases including PubMed, Web of Science, Embase and the Cochrane Library were searched for clinical reports. Additional literature search was also performed by searching the reference list of included studies and latest reviews. Raw data including objective response rate, disease control rate, progression-free survival, overall survival and the incidence of major complication were extracted and pooled. RESULTS A total of 12 studies in China including 1282 patients with lung malignancy were included in this meta-analysis. The number of studies that reported data of objective response rate, disease control rate, progression-free survival, overall survival and major complication was 8, 7, 7, 6 and 7, respectively. The combination therapy of thermal ablation plus chemotherapy showed a significantly better efficacy in improving objective response rate (odds ratio = 2.73; P < 0.001) and disease control rate (odds ratio = 2.43; P < 0.001) as compared with chemotherapy alone. Thermal ablation was also a significant protective factor for progression-free survival (hazard ratio = 0.43; P < 0.001) and overall survival (hazard ratio = 0.49; P < 0.001). Besides, thermal ablation did not increase the risk of major complication (odds ratio = 0.75; P = 0.252). CONCLUSION The present meta-analysis based on these studies in China suggested that thermal ablation is a promising technique to provide better disease response and survival outcomes for patients with lung malignancy. Thermal ablation is worth further promotion in treating lung malignancy and application in clinical practice.
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Affiliation(s)
- Rongxing Liu
- Department of Thoracic and Cardiac Surgery, The Second Hospital of Longyan, Beicheng Shuangyang West Road No. 8, Xinluo District, Longyan, 364000 Fujian China
| | - Qiurong Shen
- Department of Thoracic and Cardiac Surgery, The Second Hospital of Longyan, Beicheng Shuangyang West Road No. 8, Xinluo District, Longyan, 364000 Fujian China
| | - Hongjun Lu
- Department of Thoracic and Cardiac Surgery, The Second Hospital of Longyan, Beicheng Shuangyang West Road No. 8, Xinluo District, Longyan, 364000 Fujian China
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Shang Y, Li G, Zhang B, Wu Y, Chen Y, Li C, Zhao W, Liu J. Image-guided percutaneous ablation for lung malignancies. Front Oncol 2022; 12:1020296. [PMID: 36439490 PMCID: PMC9685331 DOI: 10.3389/fonc.2022.1020296] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/19/2022] [Indexed: 10/21/2023] Open
Abstract
Image-guided percutaneous lung ablation has proven to be an alternative and effective strategy in the treatment of lung cancer and other lung malignancies. Radiofrequency ablation, microwave ablation, and cryoablation are widely used ablation modalities in clinical practice that can be performed along or combined with other treatment modalities. In this context, this article will review the application of different ablation strategies in lung malignancies.
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Affiliation(s)
- Youlan Shang
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Ge Li
- Xiangya Hospital, Central South University, Changsha, China
| | - Bin Zhang
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuzhi Wu
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanjing Chen
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Chang Li
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Zhao
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Jun Liu
- Second Xiangya Hospital, Central South University, Changsha, China
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Yang H, Li M, Mei T. Survival benefit of thermal ablation combined with chemotherapy for the treatment of stage IV nonsmall cell lung cancer: a propensity-matched analysis. Int J Hyperthermia 2022; 39:348-357. [PMID: 35164638 DOI: 10.1080/02656736.2022.2038281] [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] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the survival benefit of thermal ablation (TA) plus chemotherapy for Stage-IV nonsmall cell lung cancer (NSCLC). METHODS From the Surveillance, Epidemiology and End Results (SEER) database, data of Stage-IV NSCLC patients receiving different treatment modalities (TA plus chemotherapy vs. chemotherapy) from 2004 to 2016 were retrospectively analyzed using propensity-score matching (PSM) for covariates. Kaplan-Meier curves and the log-rank test for intergroup comparison of overall survival (OS) and lung cancer-specific survival (LCSS) and subgroup analyses in the PSM cohort evaluated possible survival benefits. Cox proportional risk models evaluated independent prognostic factors. RESULTS Among 52,574 patients, 152 received TA plus chemotherapy. After PSM, the TA plus chemotherapy and chemotherapy groups included 150 and 445 patients, respectively. Compared to the chemotherapy group, the TA plus chemotherapy group had better OS (p = 0.042) and LCSS (p = 0.031), especially in patients aged 70 and older in age-stratified subgroup analysis; no statistically significant beneficial trend was noted for patients younger than 70 years. Subgroup analysis by tumor size showed superior OS and LCSS with TA plus chemotherapy than chemotherapy for tumors ≤3.0 cm; however, no significant difference was found in subgroups with larger tumors. Multivariate analysis showed that TA plus chemotherapy was an independent prognostic factor for OS and LCSS (hazard ratio 0.70 [95% confidence interval 0.59-0.84] and 0.70 [0.58-0.84], respectively; p < 0.001). CONCLUSION TA plus chemotherapy is a potential treatment option for Stage-IV NSCLC, especially for patients aged 70 or older with tumor size ≤3 cm.
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Affiliation(s)
- Hao Yang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Mengqi Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Tonghua Mei
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
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Ueki A, Okuma T, Hamamoto S, Kageyama K, Murai K, Miki Y. Combination therapy involving radiofrequency ablation and targeted chemotherapy with bevacizumab plus paclitaxel and cisplatin in a rabbit VX2 lung tumor model. BMC Res Notes 2018; 11:251. [PMID: 29690935 PMCID: PMC5916726 DOI: 10.1186/s13104-018-3358-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/18/2018] [Indexed: 11/12/2022] Open
Abstract
Objective Radiofrequency ablation (RFA) is less effective for large tumors > 3 cm in diameter. Various studies of combination therapy using RFA and other treatments have been conducted to improve the results of RFA treatment of lung tumors, survival was extended in a tumor model when RFA was followed by concomitant use of systemic chemotherapy. Bevacizumab (BCM) is a one of molecular target drugs. Numerous clinical trials and reports have shown BCM’s effect when used in combination with cisplatin (CDDP) in lung tumor. Our objective is to evaluate the survival of concurrent, combined use of radiofrequency ablation and BCM, and platinum-doublet chemotherapy [CDDP/paclitaxel (PTX)] in a rabbit VX2 lung tumor. Results Survival times of the RFA alone, CDDP/PTX, CDDP/PTX/BCM, RFA/CDDP/PTX, and RFA/CDDP/PTX/BCM groups were significantly prolonged compared to that of the control group (P = 0.0055, P = 0.0055, P = 0.0004, P = 0.0002, P = 0.0019, respectively). Survival of the RFA/CDDP/PTX/BCM group was not significantly prolonged compared to the RFA alone (P = 0.53) and CDDP/PTX/BCM group (P = 0.68), while showing a significantly shorter survival time than that of the RFA/CDDP/PTX group (P = 0.017). The addition to BCM with combination RFA and systemic therapy with CDDP/PTX did not have a positive effect on survival.
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Affiliation(s)
- Ai Ueki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Tomohisa Okuma
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Shinichi Hamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Kazuki Murai
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
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Song GQ, Chen F, Zang F, Lu H, Lin B. Small cell lung cancer treated by radiofrequency ablation: A case report. Medicine (Baltimore) 2017; 96:e8674. [PMID: 29145298 PMCID: PMC5704843 DOI: 10.1097/md.0000000000008674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
RATIONALE The morbidity and mortality of small cell lung cancer (SCLC), an uncommon malignancy of the lung, remain high. Radiofrequency ablation (RFA) creates heat to destroy cancer cells and is usually used to treat non-SCLC, but not SCLC. PATIENT CONCERNS An 85-year-old male presented with a 2-month history of a productive cough with white phlegm and a 2-day history of hemoptysis. Chest computed tomography revealed a mass in the right lower lobe. DIAGNOSES An excision biopsy of the mass showed SCLC. INTERVENTIONS We treated the tumor with RFA. OUTCOMES At the 2-year follow-up examination, the efficacy of the RFA was evaluated as a partial response. LESSONS RFA can improve the prognosis of SCLC and should be considered for its treatment.
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Affiliation(s)
| | - Fei Chen
- Department of Respiratory Medicine
| | | | | | - Bin Lin
- Department of Respiratory Medicine
- Department of Clinical Pharmacy, Changxing People's Hospital, Huzhou, Zhejiang, P.R. China
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叶 欣, 范 卫, 王 徽, 王 俊, 古 善, 冯 威, 庄 一, 刘 宝, 李 晓, 李 玉, 杨 坡, 杨 霞, 杨 武, 陈 俊, 张 嵘, 林 征, 孟 志, 胡 凯, 柳 晨, 彭 忠, 韩 玥, 靳 勇, 雷 光, 翟 博, 黄 广, 中国抗癌协会肿瘤微创治疗专业委员会肺癌微创治疗分会. [Expert Consensus for Thermal Ablation of Primary and Metastatic Lung Tumors
(2017 Edition)]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2017; 20:433-445. [PMID: 28738958 PMCID: PMC5972946 DOI: 10.3779/j.issn.1009-3419.2017.07.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- 欣 叶
- 250014 济南, 山东大学附属省立医院肿瘤科Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
| | - 卫君 范
- 510060 广州, 中山大学肿瘤医院影像与微创介入中心Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - 徽 王
- 130012 长春, 吉林省肿瘤医院介入治疗中心Interventional Treatment Center, Jilin Provincial Tumor Hospital, Changchun 130012, China
| | - 俊杰 王
- 100191 北京, 北京大学第三医院放射治疗科Department of Radiation Oncology, Peking University 3rd Hospital, Beijing 100191, China
| | - 善智 古
- 410013 长沙, 湖南省肿瘤医院放射介入科Department of Interventional Therapy, Hunan Provincial Tumor Hospital, Changsha 410013, China
| | - 威健 冯
- 100045 北京, 首都医科大学附属复兴医院肿瘤科Department of Oncology, Fuxing Hospital Affiliated to the Capital University of Medical Sciences, Beijing 100045, China
| | - 一平 庄
- 210009 南京, 江苏省肿瘤医院介入科Department of Interventional Therapy, Jiangsu Cancer Hospital, Nanjing 210009, China
| | - 宝东 刘
- 100053 北京, 首都医科大学宣武医院胸外科Department of Thoracic Surgery, Xuanwu Hospital Affiliated to the Capital University of Medical Sciences, Beijing 100053, China
| | - 晓光 李
- 100005 北京, 北京医院肿瘤微创中心Department of Tumor Minimally Invasive Therapy, Beijing Hospital, Beijing 100005, China
| | - 玉亮 李
- 250033 济南, 山东大学第二医院介入治疗中心Interventional Treatment Center, Shandong University Second Hospital, Ji'nan 250033, China
| | - 坡 杨
- 150001 哈尔滨, 哈尔滨医科大学第四人民医院介入放射科Department of Interventional Radiology, The Fourth Hospital of Harbin Medical University, Harbin 150001, China
| | - 霞 杨
- 250014 济南, 山东大学附属省立医院肿瘤科Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
| | - 武威 杨
- 100071 北京, 解放军307医院肿瘤微创治疗科Department of Tumor Minimally Invasive Therapy, 307 Hospital, Beijing 100071, China
| | - 俊辉 陈
- 510060 广州, 中山大学肿瘤医院影像与微创介入中心Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - 嵘 张
- 518036 深圳, 北京大学深圳医院微创介入科Department of Minimally Invasive Interventional Therapy, Shenzhen Hospital of Beijing University, Shenzhen 518036, China
| | - 征宇 林
- 350005 福州, 福建医科大学附属第一医院介入科Department of Interventional Therapy, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - 志强 孟
- 200032 上海, 复旦大学肿瘤医院微创治疗科Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - 凯文 胡
- 100078 北京, 北京中医药大学东方医院肿瘤科Department of Oncology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100078, China
| | - 晨 柳
- 100083 北京, 北京肿瘤医院介入治疗科Department of Interventional Therapy, Beijing Cancer Hospital, Beijing 100083, China
| | - 忠民 彭
- 250014 济南, 山东省立医院胸外科Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
| | - 玥 韩
- 100021 北京, 中国医学科学院肿瘤医院介入治疗科Department of Interventional Therapy, Tumor Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
| | - 勇 靳
- 215004 苏州, 苏州大学第二附属医院介入治疗科Department of Interventional Therapy, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - 光焰 雷
- 710061 西安, 陕西省肿瘤医院胸外科Department of Thoracic Surgery, Shanxi Provincial Tumor Hospital, Xi'an 710061, China
| | - 博 翟
- 200127 上海, 上海交通大学仁济医院肿瘤介入治疗科Tumor Interventional Therapy Center, Shanghai Renji Hospital, Shanghai 200127, China
| | - 广慧 黄
- 250014 济南, 山东大学附属省立医院肿瘤科Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250014, China
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