Microwave ablation plus chemotherapy versus chemotherapy in advanced non-small cell lung cancer: a multicenter, randomized, controlled, phase III clinical trial

Wei, Zhigang; Yang, Xia; Ye, Xin; Feng, Qian; Xu, Yong; Zhang, Licheng; Sun, Weize; Dong, Yuting; Qi, Meng; Li, Tao; Wang, Chuntang; Li, Guangxu; Zhang, Kaixian; Li, Peishun; Bi, Jian; Xue, Guoliang; Sun, Yahong; Sheng, Lijun; Liu, Bin; Yang, Guohua; Ren, Haitao; Wang, Junye; Sun, Lijun; Chen, Shaoshui; Geng, Dianzhong; Zhang, Benhua; Xu, Xin; Zhang, Liangming; Sun, Duoli; Xu, Xiaotong; Diao, Cunqi; Huang, Guanghui; Li, Wenhong; Han, Xiaoying; Wang, Jiao; Meng, Min; Ni, Yang; Zheng, Ai; Fan, Weijun; Li, Yuliang; Fan, Li; Fan, Hua; Zou, Zhigeng; Li, Qingyu; Tian, Hui

doi:10.1007/s00330-019-06613-x

Cited by 32 publications

(36 citation statements)

References 42 publications

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“…The overall prognosis of NSCLC remains dismal, with the 5-year survival rate of 16% as reported [4]. In recent decades, thermal ablation has been reported as a primary therapeutic strategy or/and an adjuvant to other treatments for NSCLC, or for the earlystage patients with limited pulmonary reserve who cannot tolerate the surgery [5][6][7], with a high technical success rate up to 96% according to a meta-analysis [8]. Of these, radiofrequency ablation (RFA) and microwave ablation (MWA) are the two most common types, while the latter has the advantages of a higher intra-tumoral temperatures, a larger ablation scope, decreased ablation duration, and deeper penetration [9].…”

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

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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.

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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

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“…The incidence of pulmonary infection is 1%-6%. 13,55,60 Prophylactic antibiotics can be used 30 to 60 minutes before procedure and once again in 24 hours. It can be extended to 48 to 72 hours for patients older than 70 years, or those with chronic obstructive pulmonary disease, poorly controlled diabetes, tumors >4 cm or low immunity.…”

Section: Infectionmentioning

confidence: 99%

“…It can be extended to 48 to 72 hours for patients older than 70 years, or those with chronic obstructive pulmonary disease, poorly controlled diabetes, tumors >4 cm or low immunity. 55,60 Pulmonary infections should be suspected if body temperature is still >38.5 • C 5 days after ablation. Chest tube should be placed for pulmonary or chest abscesses.…”

Section: Infectionmentioning

confidence: 99%

“…The incidence of pulmonary infection is 1%–6% 13 , 55 , 60 . Prophylactic antibiotics can be used 30 to 60 minutes before procedure and once again in 24 hours.…”

Section: Complicationsmentioning

confidence: 99%

“…Prophylactic antibiotics can be used 30 to 60 minutes before procedure and once again in 24 hours. It can be extended to 48 to 72 hours for patients older than 70 years, or those with chronic obstructive pulmonary disease, poorly controlled diabetes, tumors >4 cm or low immunity 55 , 60 . Pulmonary infections should be suspected if body temperature is still >38.5°C 5 days after ablation.…”

Section: Complicationsmentioning

confidence: 99%

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Image‐guided percutaneous microwave ablation of early‐stage non–small cell lung cancer

2020

Asia-Pac J Clncl Oncology

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Although surgical lobectomy with systematic mediastinal lymph node evaluation is considered as the "gold standard" for management of early stage non-small cell lung cancer (NSCLC), image-guided percutaneous thermal ablation has been increasingly used for medically inoperable patients. Radiofrequency ablation (RFA) is a researchbased technique that has the most studies for medically inoperable early-stage NSCLC. Other thermal ablation techniques used to treat pulmonary tumors include microwave ablation (MWA), cryoablation and laser ablation. MWA has several advantages over RFA including reduced procedural time, reduced heat-sink effect, large ablation zones, decreased susceptibility to tissue impedance, and simultaneous use of multiple antennae. This review article highlights the most relevant updates of MWA for the treatment of early-stage NSCLC, including mechanism of action, clinical outcomes, potential complications, the existing technique problems and future directions.

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The Effects of Localized Heat on the Hallmarks of Cancer

Hannon

Tansi

Hilger

et al. 2021

Advanced Therapeutics

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Heat has been used to treat tumors for thousands of years. There are reports of the Egyptians and Greek philosophers using such treatments as far back as 3000 BC and 500 BC respectively for various solid tumors. Albeit, in these cases, the treatment was not very controlled and consisted of hot sticks or blades placed against tissue in order to thermally ablate the tumor. It was not until recent times that the application of heat through various mediums enabled a more controlled, localized, and consistent method of treating tumors. While the therapeutic potential of this treatment has become more apparent, the mechanisms related to its efficacy are only recently beginning to surface. This review discusses the evidence associated with the effects of localized heat on the hallmarks of cancer. Key literature describing modulations to vasculature, cell viability, DNA damage and repair, metabolism, immune system, and tumor metastasis in response to heat will be reviewed along with considerations for its optimal implementation in the clinic to enhance the efficacy of conventional treatments.

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Microwave ablation plus chemotherapy versus chemotherapy in advanced non-small cell lung cancer: a multicenter, randomized, controlled, phase III clinical trial

Cited by 32 publications

References 42 publications

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

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

Image‐guided percutaneous microwave ablation of early‐stage non–small cell lung cancer

The Effects of Localized Heat on the Hallmarks of Cancer

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