Combination of Local Ablative Techniques with Radiotherapy for Primary and Recurrent Lung Cancer: A Systematic Review

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2023 Dec 23

PMID 38136413

Authors

Paolo Bonome

Donato Pezzulla

Valentina Lancellotta

Anna Rita Scrofani

Gabriella Macchia

Elena Rodolfino

Luca Tagliaferri

Gyorgy Kovacs

Francesco Deodato

Roberto Iezzi

Affiliations

Soon will be listed here.

Abstract

In patients with early-stage or recurrent NSCLC who are unable to tolerate surgery, a benefit could derive only from a systemic therapy or another few forms of local therapy. A systematic review was performed to evaluate the feasibility and the effectiveness of radiotherapy combined with local ablative therapies in the treatment of primary and recurrent lung cancer in terms of toxicity profile and local control rate. Six studies featuring a total of 115 patients who met eligibility criteria and 119 lesions were included. Three studies evaluated lung cancer patients with a medically inoperable condition treated with image-guided local ablative therapies followed by radiotherapy: their local control rate (LC) ranged from 75% to 91.7% with only 15 patients (19.4%) reporting local recurrence after combined modality treatment. The other three studies provided a salvage option for patients with locally recurrent NSCLC after RT: the median follow-up period varied from 8.3 to 69.3 months with an LC rate ranging from 50% to 100%. The most common complications were radiation pneumonitis (9.5%) and pneumothorax (29.8%). The proposed intervention appears to be promising in terms of toxicity profile and local control rate. Further prospective studies are need to better delineate combining LTA-RT treatment benefits in this setting.

References

Sadhukha T, Wiedmann T, Panyam J . Inhalable magnetic nanoparticles for targeted hyperthermia in lung cancer therapy. Biomaterials. 2013; 34(21):5163-71. PMC: 4673896. DOI: 10.1016/j.biomaterials.2013.03.061. View

Pusceddu C, Melis L, Sotgia B, Guerzoni D, Porcu A, Fancellu A . Usefulness of percutaneous microwave ablation for large non-small cell lung cancer: A preliminary report. Oncol Lett. 2019; 18(1):659-666. PMC: 6546981. DOI: 10.3892/ol.2019.10375. View

Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, Deluca J . Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol. 2006; 24(30):4833-9. DOI: 10.1200/JCO.2006.07.5937. View

Dupuy D, DiPetrillo T, Gandhi S, Ready N, Ng T, Donat W . Radiofrequency ablation followed by conventional radiotherapy for medically inoperable stage I non-small cell lung cancer. Chest. 2006; 129(3):738-45. DOI: 10.1378/chest.129.3.738. View

Wachsberger P, Burd R, Dicker A . Tumor response to ionizing radiation combined with antiangiogenesis or vascular targeting agents: exploring mechanisms of interaction. Clin Cancer Res. 2003; 9(6):1957-71. View

Dupuy D, Zagoria R, Akerley W, Mayo-Smith W, Kavanagh P, Safran H . Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol. 2000; 174(1):57-9. DOI: 10.2214/ajr.174.1.1740057. View

Aarts B, Klompenhouwer E, Rice S, Imani F, Baetens T, Bex A . Cryoablation and immunotherapy: an overview of evidence on its synergy. Insights Imaging. 2019; 10(1):53. PMC: 6527672. DOI: 10.1186/s13244-019-0727-5. View

Duma N, Santana-Davila R, Molina J . Non-Small Cell Lung Cancer: Epidemiology, Screening, Diagnosis, and Treatment. Mayo Clin Proc. 2019; 94(8):1623-1640. DOI: 10.1016/j.mayocp.2019.01.013. View

Olive G, Yung R, Marshall H, Fong K . Alternative methods for local ablation-interventional pulmonology: a narrative review. Transl Lung Cancer Res. 2021; 10(7):3432-3445. PMC: 8350102. DOI: 10.21037/tlcr-20-1185. View

10.

L McDevitt J, Mouli S, Nemcek A, Lewandowski R, Salem R, Sato K . Percutaneous Cryoablation for the Treatment of Primary and Metastatic Lung Tumors: Identification of Risk Factors for Recurrence and Major Complications. J Vasc Interv Radiol. 2016; 27(9):1371-1379. DOI: 10.1016/j.jvir.2016.04.005. View

11.

Lanuti M, Sharma A, Digumarthy S, Wright C, Donahue D, Wain J . Radiofrequency ablation for treatment of medically inoperable stage I non-small cell lung cancer. J Thorac Cardiovasc Surg. 2009; 137(1):160-6. DOI: 10.1016/j.jtcvs.2008.08.034. View

12.

Steber C, Hughes R, Urbanic J, Clark H, Petty W, Blackstock A . Long-Term Outcomes From a Phase 2 Trial of Radiofrequency Ablation Combined With External Beam Radiation Therapy for Patients With Inoperable Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys. 2021; 111(1):152-156. PMC: 8559790. DOI: 10.1016/j.ijrobp.2021.04.020. View

13.

Seror O . Ablative therapies: Advantages and disadvantages of radiofrequency, cryotherapy, microwave and electroporation methods, or how to choose the right method for an individual patient?. Diagn Interv Imaging. 2015; 96(6):617-24. DOI: 10.1016/j.diii.2015.04.007. View

14.

Yamauchi Y, Izumi Y, Hashimoto K, Yashiro H, Inoue M, Nakatsuka S . Percutaneous cryoablation for the treatment of medically inoperable stage I non-small cell lung cancer. PLoS One. 2012; 7(3):e33223. PMC: 3297638. DOI: 10.1371/journal.pone.0033223. View

15.

Yao W, Lu M, Fan W, Huang J, Gu Y, Gao F . Comparison between microwave ablation and lobectomy for stage I non-small cell lung cancer: a propensity score analysis. Int J Hyperthermia. 2018; 34(8):1329-1336. DOI: 10.1080/02656736.2018.1434901. View

16.

Yang N, Gong F, Cheng L, Lei H, Li W, Sun Z . Biodegradable magnesium alloy with eddy thermal effect for effective and accurate magnetic hyperthermia ablation of tumors. Natl Sci Rev. 2021; 8(1):nwaa122. PMC: 8288380. DOI: 10.1093/nsr/nwaa122. View

17.

Aufranc V, Farouil G, Abdel-Rehim M, Smadja P, Tardieu M, Aptel S . Percutaneous thermal ablation of primary and secondary lung tumors: Comparison between microwave and radiofrequency ablation. Diagn Interv Imaging. 2019; 100(12):781-791. DOI: 10.1016/j.diii.2019.07.008. View

18.

Singh M, Singh T, Soni S . Pre-operative Assessment of Ablation Margins for Variable Blood Perfusion Metrics in a Magnetic Resonance Imaging Based Complex Breast Tumour Anatomy: Simulation Paradigms in Thermal Therapies. Comput Methods Programs Biomed. 2020; 198:105781. DOI: 10.1016/j.cmpb.2020.105781. View

19.

Hinshaw J, Lee Jr F, Laeseke P, Sampson L, Brace C . Temperature isotherms during pulmonary cryoablation and their correlation with the zone of ablation. J Vasc Interv Radiol. 2010; 21(9):1424-8. PMC: 3158241. DOI: 10.1016/j.jvir.2010.04.029. View

20.

de Baere T, Tselikas L, Gravel G, Deschamps F . Lung ablation: Best practice/results/response assessment/role alongside other ablative therapies. Clin Radiol. 2017; 72(8):657-664. DOI: 10.1016/j.crad.2017.01.005. View