Multicenter Study of Metastatic Lung Tumors Targeted by Interventional Cryoablation Evaluation (SOLSTICE)

Callstrom, Matthew R.; Woodrum, David A.; Nichols, Francis C.; Palussière, Jean; Buy, Xavier; Suh, Robert D.; Abtin, Fereidoun; Pua, Bradley B.; Madoff, David C.; Bagla, Sandeep; Papadouris, Dimitrios; Fernando, Hiran C.; Dupuy, Damian E.; Healey, Terrance T.; Moore, William; Bilfinger, Thomas V.; Solomon, Stephen B.; Yarmohammadi, Hooman; Krebs, H; Fulp, Charles J.; Hakimé, Antoine; Tselikas, Lambros; Baère, Thierry De

doi:10.1016/j.jtho.2020.02.022

Cited by 81 publications

(69 citation statements)

References 22 publications

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“…This may be related to the use of a TPS that ensures adequate coverage of each tumor to its surface. This series demonstrated high rates of LC at 2 years for tumors with an average volume of 11.6cm 3 (range 0.57–62.8), while LC declines when treating tumor volumes greater than 3 cm in diameter with IGTA [ 9 , 31 , 38 , 39 ]. from the use of multiple catheters to attain optimal dosimetry to ensure adequate tumor coverage and deliver non-uniform doses that can facilitate the delivery of very high doses to certain regions of the tumor while minimizing exposure to critical structures that may juxtapose on another edge of the target.…”

Section: Discussionmentioning

confidence: 99%

Outcomes with multi-disciplinary management of central lung tumors with CT-guided percutaneous high dose rate brachyablation

et al. 2021

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Background Centrally located lung tumors present treatment challenges given their proximity to mediastinal structures including the central airway, esophagus, major vessels, and heart. Therapeutic options can be limited for medically inoperable patients, particularly if they have received previous thoracic radiotherapy. High dose rate (HDR) brachyablation was developed to improve the therapeutic ratio for patients with central lung tumors. The purpose of this study is to report initial safety and efficacy outcomes with this treatment for central lung malignancies. Methods From September 2015 to August 2019, a total of 25 patients with 37 pulmonary tumors were treated with percutaneous HDR brachyablation. Treatment was delivered by a multi-disciplinary team of interventional radiologists, pulmonologists, and radiation oncologists. Twenty-three patients received a median dose of 21.5 Gy (range 15–27.5) in a single fraction, whereas two patients received median dose of 24.75 Gy (range 24–25.5) over 2–3 fractions. Tumor local control (LC) was evaluated by Response Evaluation Criteria in Solid Tumors v1.1. Treatment-related toxicities were graded by Common Terminology Criteria for Adverse Events v5.0, with adverse events less than 90 days defined as acute, and those occurring later were defined as late. LC, progression-free survival (PFS), and overall survival (OS) rates were estimated by the Kaplan–Meier method. Results Of 37 treated tumors, 88% were metastatic. Tumor location was central and ultra-central in 24.3% and 54.1%, respectively. Average tumor volume was 11.6 cm3 (SD 12.4, range 0.57–62.8). Median follow-up was 19 months (range 3–48). Two–year LC, PFS, and OS were 96.2%, 29.7%, and 65.5%, respectively. Thirteen of 39 (33.3%) catheter implantation procedures were associated with trace minor pneumothorax requiring no intervention, 1 (2.5%) procedure with minor radiographic pulmonary hemorrhage, and 4 (10.3%) with major pneumothorax requiring chest tube insertions. All procedural complications resolved within 24 h from treatment. Acute grade 1–2 toxicity was identified in 4 patients, whereas none developed late toxicity beyond 90 days of follow-up. Conclusion Percutaneous HDR brachyablation is a safe and promising treatment option for centrally located primary and metastatic lung tumors. Future comparisons with stereotactic body radiotherapy and other ablative techniques are warranted to expand multi-disciplinary management options.

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Section: Discussionmentioning

confidence: 99%

Outcomes with multi-disciplinary management of central lung tumors with CT-guided percutaneous high dose rate brachyablation

et al. 2021

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“…After a second CA for local recurrence treatment, the response rate without local recurrence was 91.1% at 12 months and 84.4% at 24 months. The mean OS rate at 12 and 24 months was 97.6% and 86.6% [97]. The results of both studies demonstrated the efficacy and safety of this technique in the treatment of OLD.…”

Section: Oligometastatic Lung Diseasementioning

confidence: 66%

Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

et al. 2021

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Image-guided percutaneous lung ablation has proven to be a valid treatment alternative in patients with early-stage non-small cell lung carcinoma or oligometastatic lung disease. Available ablative modalities include radiofrequency ablation, microwave ablation, and cryoablation. Currently, there are no sufficiently representative studies to determine significant differences between the results of these techniques. However, a common feature among them is their excellent tolerance with very few complications. For optimal treatment, radiologists must carefully select the patients to be treated, perform a refined ablative technique, and have a detailed knowledge of the radiological features following lung ablation. Although no randomized studies comparing image-guided percutaneous lung ablation with surgery or stereotactic radiation therapy are available, the current literature demonstrates equivalent survival rates. This review will discuss image-guided percutaneous lung ablation features, including available modalities, approved indications, possible complications, published results, and future applications.

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“…In a long-term analysis of 47 stage I NSCLC treated with cryoablation, the 5-year cancer-specific survival rate was 56.6+/−16.5% and 5-year progression free survival rate was 87.9+/−9% [50]. There were two randomized controlled trials, the ECLIPSE trial [51] and SOLSTICE trial [52], evaluating cryoablation of metastatic lung tumors, which report favorable safety and efficacy, but are out of the scope of this chapter.…”

Section: Efficacy Of Cryoablationmentioning

confidence: 99%

Image-Guided Ablative Therapies for Lung Tumors

Chan¹,

Lau²,

Ng³

2021

Lung Cancer - Modern Multidisciplinary Management

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While the gold standard for early stage lung cancers is still surgical resection, many patients have comorbidities or suboptimal lung function making surgery unfavorable. At the same time, more and more small lung nodules are being incidentally discovered on computer tomography (CT), leading to the discovery of pre-malignant or very early stage lung cancers without regional spread, which could probably be eradicated without anatomical surgical resection. Various ablative energies and technologies are available on the market, including radiofrequency ablation, microwave ablation, cryoablation, and less commonly laser ablation and irreversible electroporation. For each technology, the mechanism of action, advantages, limitations, potential complications and evidence-based outcomes will be reviewed. Traditionally, these ablative therapies were done under CT guidance with percutaneous insertion of ablative probes. Recently, bronchoscopic ablation under ultrasound, CT, or electromagnetic navigation bronchoscopy guidance is gaining popularity due to improved navigation precision, reduced pleural-based complications, and providing a true “wound-less” option.

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Multicenter Study of Metastatic Lung Tumors Targeted by Interventional Cryoablation Evaluation (SOLSTICE)

Cited by 81 publications

References 22 publications

Outcomes with multi-disciplinary management of central lung tumors with CT-guided percutaneous high dose rate brachyablation

Outcomes with multi-disciplinary management of central lung tumors with CT-guided percutaneous high dose rate brachyablation

Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

Image-Guided Ablative Therapies for Lung Tumors

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