Percutaneous Radiofrequency Ablation for Inoperable Non–Small Cell Lung Cancer and Metastases: Preliminary Report

Lee, Jeong Min; Jin, Gong Yong; Goldberg, S. Nahum; Lee, Yong-Cheol; Chung, Gyung Ho; Han, Young Min; Lee, Sang Yong; Kim, Chong Soo

doi:10.1148/radiol.2301020934

Cited by 309 publications

(259 citation statements)

References 29 publications

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“…Other energy sources are available, including microwave, cryoablation and laser (2,7,10,11). The type of energy that can be used will depend on the patient, location and nature of the tumor, treatment goal, and operator experience or preference.…”

Section: Types Of Energymentioning

confidence: 99%

“…Surgical treatment combining lobectomy or pneumonectomy and hilar and/or mediastinal lymphadenectomy remains the only proven curative treatment of stage I-II NSCLC. However, 15-30% of patients may not benefit from surgery, most often due to poor general condition, comorbid cardiopulmonary disease as insufficient pulmonary reserve, or a high surgical risk (1)(2)(3)(4)(5).…”

Section: Types Of Energymentioning

confidence: 99%

“…The ideal target lesion for ablation is a lesion measuring less than 3 cm diameter, and not in contact with large vessels or bronchi, mediastinum and chest wall (2,13,(24)(25)(26)(27)(28)(29)(30).…”

Section: Indicationsmentioning

confidence: 99%

“…More uncommon indications are reported in the literature, including palliation of symptoms such as pain, cough or hemoptysis, recurrent disease in a radiation field, or tumor debulking (2,3,14,28,(31)(32)(33)(34) (Fig. 5).…”

Section: Indicationsmentioning

confidence: 99%

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Percutaneous ablation of malignant thoracic tumors

Ghaye

2013

Journal of the Belgian Society of Radiology

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Lung cancer is the leading cause of death related to cancer. Fifteen to thirty percent of patients with a localized lung cancer are actually inoperable as they present with poor general condition, limited cardiopulmonary function, or a too high surgical risk. Therefore, minimally invasive treatments are needed and percutaneous ablation seems an attractive option. Thermal ablation can be performed by delivering heat (radiofrequency, microwave, laser) or cold (cryotherapy) through a needle inserted into the tumor under CT guidance. The ideal lesion is less than 2 or 3 cm in diameter. Success of percutaneous thermal ablation appears to be close to those of surgery for localized lung cancer. Nevertheless studies are still needed to definitely assess the role of ablation compared to other emerging techniques, as stereo tactic radiotherapy as well as potential synergy with other treatments.

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Section: Types Of Energymentioning

confidence: 99%

Section: Types Of Energymentioning

confidence: 99%

Section: Indicationsmentioning

confidence: 99%

Section: Indicationsmentioning

confidence: 99%

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Percutaneous ablation of malignant thoracic tumors

Ghaye

2013

Journal of the Belgian Society of Radiology

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“…MAGNETIC RESONANCE IMAGING (MRI) has been used to provide guidance and monitoring during thermal ablation of tissues (1)(2)(3)(4)(5)(6)(7)(8). The ultimate lesion (coagulation) volume has been determined with T2-weighted turbo-spin-echo (TSE) or contrast-enhanced T1-weighted spin-echo (SE) images (9,10).…”

mentioning

confidence: 99%

Magnetic resonance imaging and model prediction for thermal ablation of tissue

Chen

Barkauskas

Nour

et al. 2007

Magnetic Resonance Imaging

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Purpose: To monitor and predict tissue temperature distributions and lesion boundaries during thermal ablation by combining MRI and thermal modeling methods. Materials and Methods:Radiofrequency (RF) ablation was conducted in the paraspinal muscles of rabbits with MRI monitoring. A gradient-recalled echo (GRE) sequence via a 1.5T MRI system provided tissue temperature distribution from the phase images and lesion progression from changes in magnitude images. Post-ablation GRE estimates of lesion size were compared with post-ablation T2-weighted turbo-spin-echo (TSE) images and hematoxylin and eosin (H&E)-stained histological slices. A three-dimensional (3D) thermal model was used to simulate and predict tissue temperature and lesion size dynamics. Results:The lesion area estimated from repeated GRE images remained constant during the post-heating period when the temperature of the lesion boundary was less than a critical temperature. The final lesion areas estimated from multi-slice (M/S) GRE, TSE, and histological slices were not statistically different. The model-simulated tissue temperature distribution and lesion area closely corresponded to the GRE-based MR measurements throughout the imaging experiment. Conclusion:For normal tissue in vivo, the dynamics of tissue temperature distribution and lesion size during RF thermal ablation can be 1) monitored with GRE phase and magnitude images, and 2) simulated for prediction with a thermal model.

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Association of Long-term Outcomes and Survival With Multidisciplinary Salvage Treatment for Local and Regional Recurrence After Stereotactic Ablative Radiotherapy for Early-Stage Lung Cancer

et al. 2018

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Importance Stereotactic ablative radiotherapy (SABR) is first-line treatment for patients with early-stage non–small cell lung cancer (NSCLC) who cannot undergo surgery. However, up to 1 in 6 such patients will develop isolated local recurrence (iLR) or isolated regional recurrence (iRR). Little is known about outcomes when disease recurs after SABR, or about optimal management strategies for such recurrences. Objective To characterize long-term outcomes for patients with iLR or iRR after SABR for early-stage NSCLC with the aim of informing treatment decision making for these patients with potentially curable disease. Design, Setting, and Participants In this cohort study, a retrospective review was conducted of 912 patients prospectively enrolled in an institutional database at a tertiary cancer center from January 1, 2004, through December 31, 2014. Main Outcomes and Measures Overall survival, progression-free survival, recurrence patterns, demographics, salvage techniques, patterns of salvage failure, and toxic effects. Results Of the 912 patients in the study (456 women and 456 men; median age, 72 years [range, 46-91 years]), 756 (82.9%) had T1 tumors at initial diagnosis; 502 tumors (55.0%) were adenocarcinomas and 309 tumors (33.9%) were squamous cell carcinomas. Of 912 patients with early-stage I to II NSCLC who received definitive SABR (50 Gy in 4 fractions or 70 Gy in 10 fractions), 102 developed isolated recurrence (49 with iLR and 53 with iRR), and 658 had no recurrence. Median times to recurrence after SABR were 14.5 months (range, 1.5-60.8 months) for iLR and 9.0 months (range, 1.9-70.7 months) for iRR; 39 of 49 patients (79.6%) with iLR and 48 of 53 patients (90.6%) with iRR underwent salvage with reirradiation, surgery, thermal ablation, or chemotherapy. Median follow-up times for patients with iLR or iRR were 57.2 months (interquartile range, 37.7-87.6 months) from initial SABR and 38.5 months (interquartile range, 19.9-69.3 months) from recurrence. Rates of overall survival at 5 years from initial SABR were no different between patients with iLR and salvage treatment (57.9%) and patients with no recurrence (54.9%; hazard ratio, 0.89; 95% CI, 0.56-1.43; P = .65) but were lower for patients with iRR and salvage treatment (31.1%; hazard ratio, 1.43; 95% CI, 1.00-2.34; P = .049). Patients receiving salvage treatment had longer overall survival than patients who did not (median, 37 vs 7 months after recurrence; hazard ratio, 0.40; 95% CI, 0.09-0.66; P = .006). Twenty-four of 87 patients (27.6%) who received salvage treatment for iLR or iRR subsequently developed distant metastases. No patient experienced grade 5 toxic effects after salvage treatment. Conclusions and Relevance Life expectancy after salvage treatment for iLR was similar to that for patients without ...

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Percutaneous Radiofrequency Ablation for Inoperable Non–Small Cell Lung Cancer and Metastases: Preliminary Report

Abstract: RF ablation appears to be a safe and promising procedure for the treatment of inoperable NSCLC and metastases.

Cited by 309 publications

References 29 publications

Percutaneous ablation of malignant thoracic tumors

Percutaneous ablation of malignant thoracic tumors

Magnetic resonance imaging and model prediction for thermal ablation of tissue

Association of Long-term Outcomes and Survival With Multidisciplinary Salvage Treatment for Local and Regional Recurrence After Stereotactic Ablative Radiotherapy for Early-Stage Lung Cancer

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