Co‐ablation versus cryoablation for the treatment of stage III–IV non‐small cell lung cancer: A prospective, noninferiority, randomized, controlled trial (RCT)

Abstract

Background This study compared a co‐ablation (CA) system, which is a novel ablation device, with an argon‐helium cryoablation (AHC) system. We aimed to compare the efficacy and safety of CA and AHC for the treatment of stage III–IV non‐small cell lung cancer (NSCLC). Methods We conducted a multicenter randomized controlled trial (RCT) to determine whether CA was noninferior to AHC. The primary efficacy endpoints were the iceball coverage rate (ICR) and the disease control rate (DCR) one month after treatment. Noninferiority was declared if the lower limit of two‐sided 95% confidence interval (CI) was less than 10%. The ICR and DCR were identified by logistic regression. Treatment safety was assessed. Results A total of 81 patients underwent randomization (41 assigned to the CA and 40 assigned to the AHC groups)and transthoracic ablation. The ICRs in the CA and AHC groups were 99.24% ± 2.18% and 98.66% ± 3.79%, respectively. Central lesions were associated with an increased risk of an incomplete ICR. The DCRs in the CA and AHC groups were 97.6% and 95%, respectively. A smaller lesion area in the CA group was significantly correlated with a better DCR. The rate of complications was 29.26% in the CA group and 30% in the AHC group. (P = 0.943). There was less probe usage per patient in the CA group. Conclusions We determined that CA is noninferior to AHC in terms of efficacy and safety for the treatment of stage III–IV NSCLC. A smaller lesion area in the CA group was significantly correlated with a better DCR. Key points CA was noninferior to AHC for stage III–IV NSCLC.

Untargeted metabolomics profiling in a mouse model of lung cancer treated with thermal ablation

“…With this technology, the study of the effects of freezing and heating ablation becomes more convenient and intuitive. In addition, previous experiments [ 11–13 ]and clinical trials [ 14 ] have proven the efficacy and safety of this system. Thus, our study evaluated metabolic profiles after performing the two modes of the combined ablation system to provide insight into the different effects of freezing and heating mechanisms.…”

“…The tumor was then thawed with anhydrous ethanol steam until the central tumor temperature reached 0°C, after which the probe was removed [ 16 ]. For hyperthermal ablation, the tumor was heated using anhydrous ethanol steam, the temperature of which reached as high as 80°C upon transition in the probe [ 14 ]. The probes were pulled out until the boundaries of the tumor were carbonized.…”

Innovative Invasive Loco-Regional Techniques for the Treatment of Lung Cancer

“…The authors also reported a local progression rate of 10.9%. A recent randomized controlled trial performed by Yang et al reported the response of 41 stage III and IV NSCLC patients compared to co-ablation therapy [ 83 ]. Co-ablation therapy exists as a combination of CRA and thermal ablation using a single probe.…”

Cryoablation and immune synergistic effect for lung cancer: A review

“…The number of ablation needles and tumor size were associated with the risk of pneumothorax and intrapulmonary hemorrhage. Yang, W. et al (40) reported on a multicenter randomized controlled trial (RCT) evaluating the efficacy and safety of cryoablation for stage III-IV NSCLC. The primary efficacy endpoints were ice hockey coverage rate (ICR) and disease control rate (DCR) at 1 month after treatment.…”