Midterm Local Efficacy and Survival after Radiofrequency Ablation of Lung Tumors with Minimum Follow-up of 1 Year: Prospective Evaluation

Baère, Thierry De; Palussière, Jean; Aupérin, Anne; Hakimé, Antoine; Abdel‐Rehim, Mohamed; Kind, Michèle; Dromain, Clarisse; Ravaud, Alain; Tebboune, Nathalie; Boige, Valérie; Malka, David; Lafont, Clarisse; Ducreux, Michel

doi:10.1148/radiol.2402050807

Cited by 322 publications

(155 citation statements)

References 21 publications

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“…(17). Despite a possible transient decrease during the first 3 weeks after ablation, the overall respiratory function tested at 3, 6 or 12 months after the intervention shows no degradation (25,41,42,47). …”

Section: Complicationsmentioning

confidence: 88%

“…Studies have reported more than 80% of treatment failure when the rim of ground-glass was not identified on control CT (39,40). When the total area of the thermal injury is four times that of the tumor, the success rate of complete necrosis is 96% whereas it falls to 80% if this proportion is not reached (41). Similarly, when the ablation volume is more than three times the tumor volume, tumor destruction is complete in 83% against 61% when this proportion is not reached (27).…”

Section: Lasermentioning

confidence: 99%

“…In case of incomplete resection, survival drops to 13 and 7% at 5 and 10 years, respectively (43). After percutaneous ablation of pulmonary metastatic lesions, the survival is 64 to 78% at 2 years and 27 to 57% at 5 years (26,29,30,41,44) (Table II). Results are significantly higher in case of combined ablation / chemotherapy than chemotherapy alone (87 versus 33%) (45).…”

Section: Pulmonary Metastasesmentioning

confidence: 99%

“…CT morphological analysis has limitations as an incomplete treatment may only be depicted after several months of follow-up in some cases (41,56). MRI could better appreciate an early recurrence thanks to its superior contrast resolution (7,14,21).…”

mentioning

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: Complicationsmentioning

confidence: 88%

Section: Lasermentioning

confidence: 99%

Section: Pulmonary Metastasesmentioning

confidence: 99%

mentioning

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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“…24 Ninety-seven of 100 targeted tumors were treated and showed an overall survival rate at 71% and a lung disease-free survival at 18 months of 34%. 24 At 18 months, the overall survival rates were 76% for primary lung tumors and 71% for metastatic disease. This study also reports a 54% rate of pneumothorax, with chest tube placement in 9% of the procedures.…”

Section: Outcomes and Comparison Of Thermal Ablation Techniquesmentioning

confidence: 99%

Current Status of Thermal Ablation Treatments for Lung Malignancies

Dupuy

Shulman²

2010

Semin intervent Radiol

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About 75% of lung cancer patients are not surgical candidates, either due to advanced disease or medical comorbidities. Furthermore, conventional treatments that can be offered to these patients are beneficial only to a small percentage of them. Thermal ablation is a minimally invasive treatment that is commonly used in this group of patients, and which has shown promising results. Currently, the most widely used ablation techniques in the treatment of lung malignancies are radiofrequency ablation (RFA), microwave ablation, and cryoablation. Although the most studied technique is RFA, recent studies with microwave ablation and cryoablation have shown some advantages over RFA. This article reviews the application of thermal ablation in the thorax, including patient selection, basic aspects of procedure technique, imaging follow-up, treatment outcomes, and comparison of ablation techniques.

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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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Midterm Local Efficacy and Survival after Radiofrequency Ablation of Lung Tumors with Minimum Follow-up of 1 Year: Prospective Evaluation

Abstract: RF ablation has a high local efficacy and is well tolerated.

Cited by 322 publications

References 21 publications

Percutaneous ablation of malignant thoracic tumors

Percutaneous ablation of malignant thoracic tumors

Current Status of Thermal Ablation Treatments for Lung Malignancies

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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