Microwave ablation as local consolidative therapy for patients with extracranial oligometastatic EGFR-mutant non-small cell lung cancer without progression after first-line EGFR-TKIs treatment

Ni, Yang; Ye, Xin; Yang, Xia; Huang, Guanghui; Li, Wenhong; Wang, Jiao; Han, Xiaoying; Wei, Zhigang; Meng, Min

doi:10.1007/s00432-019-03043-6

Cited by 38 publications

(45 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study encompasses several NSCLCs that were locally recurrent post-radiotherapy, which had local control with subsequent MWA, illustrating the utility of MWA as salvage therapy post-radiotherapy. 35 There is also ongoing investigation into the role of MWA in the management of oligometastatic NSCLC 36 and in advanced NSCLC as an adjunct to chemotherapy. 37 MWA may have a role in the treatment of NSCLC as a salvage option after development of acquired resistance to tyrosine kinase inhibitors.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcome following microwave ablation of early‐stage non‐small cell lung cancer

Zhao

Steinke

2020

J Med Imag Rad Onc

View full text Add to dashboard Cite

Introduction: This study aimed to evaluate the long-term outcome of microwave ablation (MWA) of early-stage non-small cell lung cancer (NSCLC), including response to treatment and survival. Methods: This retrospective study was conducted on consecutive patients who underwent computed tomography-guided MWA of early-stage NSCLC (no evidence of nodal or distant metastasis) from November 2010 to December 2014 at our institution. Data were collected from systematic review of patient charts and imaging. Procedural complications, response to treatment and survival were assessed. Results: 34 early-stage (T1a-T3N0M0) NSCLCs in 30 patients were treated with a total of 41 MWA sessions. There were no intraprocedural or 30-day post-procedural deaths. The most common complication was pneumothorax, encountered in 24 (59%) microwave ablation sessions, six (15%) of which required chest tube insertion. Over a median computed tomography follow-up period of 39 months (range 3-89), 24 (71%) NSCLCs demonstrated local control, while 10 (29%) demonstrated local progression. Nodal/distant progression was more common than local progression, with 15 of the 30 patients (50%) having nodal or distant metastases at follow-up. Patient survival status was followed up over a median period of 56.5 months (range 10-107). Median overall survival and 5-year overall survival were 56.5 months (95% confidence interval, 26-not reached) and 46.7% (95% confidence interval, 31.8-68.4), respectively. Conclusion: MWA is safe and effective at achieving local control of early-stage NSCLC and may prolong patient survival. Nodal or distant metastases were the dominant manifestations of disease progression at long-term follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Long‐term outcome following microwave ablation of early‐stage non‐small cell lung cancer

Zhao

Steinke

2020

J Med Imag Rad Onc

View full text Add to dashboard Cite

show abstract

“…It was revealed that the OS for NSCLC patients treated with thermal ablation has a wide range of 10.6-71.6 months [15,16]. Although previous studies have reported the predictors of OS after thermal ablation [17][18][19], these predictors have been investigated generally across different stage and response status to previous therapies. Unfortunately, the ability of these predictors in predicting survival in NSCLC patients treated with MWA is limited and patients with different characteristics who may benefit most from MWA are still ambiguous.…”

Section: Introductionmentioning

confidence: 99%

Survival prediction for non-small cell lung cancer patients treated with CT-guided microwave ablation: development of a prognostic nomogram

et al. 2021

International Journal of Hyperthermia

View full text Add to dashboard Cite

Objectives: To explore the outcomes of CT-guided percutaneous microwave ablation (MWA) in nonsmall 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 ¼ 176; validation cohort: n ¼ 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 ¼ 0.030), tumor stage (HR, 1.38; 95% CI, 1.07-1.79; p ¼ 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.

show abstract

“…Regarding complications, additional grade ≥3 toxicities with LCTs were reported in four of 12 studies with available information, including seven cases of grade 5 toxicities. Among five studies of patients with lung cancer, two reported grade 5 toxicities 30,35 and two had higher rates of serious complications after LCT 41 . In the colorectal cancer study conducted by Ruo et al 36 bowel surgery resulted in additional complications, including two cases of 30-day mortality and serious perioperative morbidity (20.5%).…”

Section: Discussionmentioning

confidence: 99%

“…Ruo et al 36 reported a serious postoperative morbidity rate of 20.5%, with two patients developing grade 5 complications within 30 days of elective colorectal surgery. Ni et al 41 reported that 9.3% of patients needed chest tube insertion, while no serious toxicities were reported in the control arm. Otherwise, no significant additional toxicities due to LCTs were reported in eight studies in which LCT consisted mainly of radiotherapy (Table 5).…”

Section: Complicationsmentioning

confidence: 98%

Benefits of local consolidative treatment in oligometastases of solid cancers: a stepwise-hierarchical pooled analysis and systematic review

et al. 2021

View full text Add to dashboard Cite

We conducted a meta-analysis of articles published in PubMed, MEDLINE, EMBASE, and Cochrane library to investigate the effectiveness of local consolidative therapy (LCT) against oligometastases. Data from randomized controlled trials (RCTs), balanced studies, and all studies combined were analyzed in a hierarchical manner. Pooled analyses of 31 studies (including seven randomized trials) investigating the effectiveness of LCT on overall survival revealed odds ratios of 3.04, 2.56, and 1.41 for all studies, balanced studies, and RCTs, respectively (all p < 0.05). The benefit of LCT was more prominent in patients with non-small cell lung and colorectal cancers than in those with prostate and small cell lung cancers. Moreover, the benefit of LCT was smaller in patients with high metastatic burdens (p = 0.054). In four of 12 studies with available information, additional grade ≥3 toxicities due to LCTs were reported. Overall, LCT is beneficial for patients with oligometastases, although such benefits are less evident in RCTs than in observational studies. Appropriate LCTs should be carefully selected considering their feasibility, disease type, and metastatic burden.

show abstract

Microwave ablation as local consolidative therapy for patients with extracranial oligometastatic EGFR-mutant non-small cell lung cancer without progression after first-line EGFR-TKIs treatment

Cited by 38 publications

References 28 publications

Long‐term outcome following microwave ablation of early‐stage non‐small cell lung cancer

Long‐term outcome following microwave ablation of early‐stage non‐small cell lung cancer

Survival prediction for non-small cell lung cancer patients treated with CT-guided microwave ablation: development of a prognostic nomogram

Benefits of local consolidative treatment in oligometastases of solid cancers: a stepwise-hierarchical pooled analysis and systematic review

Contact Info

Product

Resources

About