Chinese expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors

Abstract

Although surgical resection is the primary means of curing both primary and metastatic lung cancers, about 80% of lung cancers cannot be removed by surgery. As most patients with unresectable lung cancer receive only limited benefits from traditional radiotherapy and chemotherapy, many new local treatment methods have emerged, including local ablation therapy. The Minimally Invasive and Comprehensive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association has organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures and criteria for selecting treatment candidates and assessing outcomes; and for preventing and managing post-ablation complications.

Short-Term Outcomes and Safety of Computed Tomography-Guided Percutaneous Microwave Ablation of Solitary Adrenal Metastasis from Lung Cancer: A Multi-Center Retrospective Study

“…In a microwave electromagnetic field, water molecules, protein molecules, and other polar molecules within the tumor tissue will vibrate at high speeds, resulting in collision and mutual friction between molecules. This can produce temperatures of 60–150℃ in a short time, leading to coagulation necrosis of cells (9101116). …”

“…Its use is gradually increasing because it induces little trauma with high thermal efficiency and good repeatability for many solid malignancies, such as lung, liver, bone, kidney, and other solid tumors (7891011). However, using MWA in adrenal metastasis from lung cancer has only been reported in a few cases.…”

Safety and clinical outcomes of computed tomography‐guided percutaneous microwave ablation in patients aged 80 years and older with early‐stage non‐small cell lung cancer: A multicenter retrospective study

“…Several image-guided percutaneous thermal ablation technologies (eg, radiofrequency ablation [RFA], microwave ablation [MWA], and cryoablation) have been developed as favorable therapeutic options for patients who are not candidates for surgery because of poor cardiopulmonary reserve, anatomic constraints that limit resection, failure of traditional therapies, or refusal to undergo surgical procedures. [7][8][9] Compared with RFA, MWA generates greater temperatures and requires shorter treatment time. 10 In MWA, energy is not distributed by means of an electric current, which increases the heating radius in the poor thermal conduction environment of the lung.…”

Safety and efficacy of thermal ablation for subpleural lung cancers

“…Previously, patients with unresectable lung cancer could only receive traditional radiotherapy and chemotherapy, but thermal ablation has recently been shown to be safe and effective for the treatment of lung cancer. 15 However, tumor location is closely associated with therapeutic efficacy and complications. 3,10 Subpleural lung cancers including tumors under the cervical, costal, diaphragmatic, and mediastinal pleura exhibit different characteristics during local thermal ablation.…”

“…The exclusion criteria were: (i) poorly-controlled infection, (ii) severe coagulation dysfunction, (iii) lung failure, (iv) an Eastern Cooperative Oncology Group performance score > 3, and (v) chest wall muscle involvement. 15 Eighty-nine patients (59 men and 30 women, mean age 54.2 years) with 101 lung tumors were finally included in this study.…”