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CardioVascular and Interventional Radiology

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01-02-2015 | Clinical Investigation

Microwave Ablation in Combination with Chemotherapy for the Treatment of Advanced Non-Small Cell Lung Cancer

Authors: Zhigang Wei, Xin Ye, Xia Yang, Aimin Zheng, Guanghui Huang, Wenhong Li, Xiang Ni, Jiao Wang, Xiaoying Han

Published in: CardioVascular and Interventional Radiology | Issue 1/2015

Abstract

Purpose

To verify whether microwave ablation (MWA) used as a local control treatment had an improved outcome regarding advanced non-small cell lung cancer (NSCLC) when combined with chemotherapy.

Methods

Thirty-nine patients with histologically verified advanced NSCLC and at least one measurable site other than the ablative sites were enrolled. Primary tumors underwent MWA followed by platinum-based doublet chemotherapy. Modified response evaluation criteria in solid tumors (mRECIST) and RECIST were used to evaluate therapeutic response. Complications were assessed using the National Cancer Institute Common Toxicity Criteria (version 3.0).

Results

MWA was administered to 39 tumors in 39 patients. The mean and median diameters of the primary tumor were 3.84 cm and 3.30 cm, respectively, with a range of 1.00–9.00 cm. Thirty-three (84.6 %) patients achieved a partial response. No correlation was found between MWA efficacy and clinicopathologic characteristics. For chemotherapy, 11 patients (28.2 %) achieved a partial response, 18 (46.2 %) showed stable disease, and 10 (25.6 %) had progressive disease. The overall objective response rate and disease control rate were 28.2 and 74.4 %, respectively. The median progression-free survival time was 8.7 months (95 % CI 5.5–11.9). The median overall survival time was 21.3 months (95 % CI 17.0–25.4). Complications were observed in 22 (56.4 %) patients, and grade 3 adverse events were observed in 3 (7.9 %) patients.

Conclusions

Patients with advanced NSCLC could benefit from MWA in combination with chemotherapy. Complications associated with MWA were common but tolerable.

Ahmedin J, Freddie B, Melissa M (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRef

Jemal A, Murray T, Ward E et al (2005) Cancer statistics. CA Cancer J Clin 55:10–30PubMedCrossRef

Mok TS, Wu YL, Thongprasert S et al (2009) Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med 361:947–957PubMedCrossRef

Rosell R, Moran T, Queralt C et al (2009) Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med 361:958–967PubMedCrossRef

Maemondo M, Inoue A, Kobayashi K et al (2010) Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med 362:2380–2388PubMedCrossRef

Mitsudomi T, Morita S, Yatabe Y et al (2010) Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial. Lancet Oncol 11:121–128PubMedCrossRef

Zhou C, Wu YL, Chen G et al (2011) Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 12:735–742PubMedCrossRef

Takahashi T, Sonobe M, Kobayashi M et al (2010) Clinicopathologic features of non-small-cell lung cancer with EML4-ALK fusion gene. Ann Surg Oncol 17:889–897PubMedCrossRef

Kwak EL, Bang YJ, Camidge DR et al (2010) Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med 363(18):1693–1703PubMedCentralPubMedCrossRef

10.

Furukawa K, Miura T, Kato Y et al (2005) Microwave coagulation therapy in canine peripheral lung tissue. J Surg Res 123:245–250PubMedCrossRef

11.

Wolf FJ, Grand DJ, Machan JT et al (2008) Microwave ablation of lung malignancies: effectiveness, CT findings, and safety in 50 patients. Radiology 247:871–879PubMedCrossRef

12.

Abbas G, Pennathur A, Landreneau RJ et al (2009) Radiofrequency and microwave ablation of lung tumors. J Surg Oncol 100:645–650PubMedCrossRef

13.

He W, Hu XD, Wu DF et al (2006) Ultrasonography-guided percutaneous microwave ablation of peripheral lung cancer. Clin Imaging 30:234–241PubMedCrossRef

14.

Cliff, Philipp, Robin et al. (2005) The efficacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesth Analg 100: 757–773

15.

Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739PubMedCentralPubMedCrossRef

16.

Herrera LJ, Fernando HC, Perry Y et al (2003) Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 125(4):929–937PubMedCrossRef

17.

Watanabe H, Okada M, Kaji Y et al (2009) New response evaluation criteria in solid tumours-revised RECIST guideline (version 1.1). Gan To Kagaku Ryoho 36:2495–2501PubMed

18.

Hasselle MD, Haraf DJ, Rusthoven KE et al (2012) Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer. J Thorac Oncol 7:376–381PubMedCrossRef

19.

Reinfuss M, Mucha-Malecka A, Walasek T et al (2011) Palliative thoracic radiotherapy in non-small cell lung cancer. An analysis of 1250 patients. Palliation of symptoms, tolerance and toxicity. Lung Cancer 71:344–349PubMedCrossRef

20.

Bezjak A, Dixon P, Brundage M et al (2002) Randomized phase III trial of single versus fractionated thoracic radiation in the palliation of patients with lung cancer (NCIC CTG SC.15). Int J Radiat Oncol Biol Phys 54:719–728PubMedCrossRef

21.

Nestle U, Nieder C, Walter K et al (2000) A palliative accelerated irradiation regimen for advanced non-small-cell lung cancer vs. conventionally fractionated 60 GY: results of a randomized equivalence study. Int J Radiat Oncol Biol Phys 48:95–103PubMedCrossRef

22.

Simon CJ, Dupuy DE, DiPetrillo TA et al (2007) Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology 243:268–275PubMedCrossRef

23.

Schneider T, Reuss D, Warth A et al (2011) The efficacy of bipolar and multipolar radiofrequency ablation of lung neoplasms - results of an ablate and resect study. Eur J Cardiothorac Surg 39:968–973PubMedCrossRef

24.

Lencioni R, Crocetti L, Cioni R et al (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol 9:621–628PubMedCrossRef

25.

Zemlyak A, Moore WH, Bilfinger TV (2010) Comparison of survival after sublobar resections and ablative therapies for stage I non-small cell lung cancer. J Am Coll Surg 211(1):68–72PubMedCrossRef

26.

Wu YL, Chu DT, Han B et al (2012) Phase III, randomized, open-label, first-line study in Asia of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non-small-cell lung cancer: evaluation of patients recruited from mainland China. Asia Pac J Clin Oncol 8(3):232–243PubMedCrossRef

27.

Wang SB, Chen JH, Cao WH et al (2005) The observation of the clinical effect for combination therapy of RFA with GP on advanced stage lung cancer. Chinese J Clin Oncol 32(11):628–630

28.

Lee H, Jin GY, Han YM et al (2012) Comparison of survival rate in primary non-small-cell lung cancer among elderly patients treated with radiofrequency ablation, surgery, or chemotherapy. Cardiovasc Intervent Radiol 35:343–350PubMedCrossRef

29.

Zhang HM, Feng WJ, Zhou L et al (2008) Addition of cluster electrode radiofrequency ablation (RFA) to paclitaxel plus carboplatin (PC) for advanced NSCLC: clinical observation. Eval Anal Drug-Use Hosp China 8(7):540–542

30.

Lee P, Weerasuriya DK, Lavori PW et al (2007) Metabolic tumor burden predicts for disease progression and death in lung cancer. Int J Radiat Oncol Biol Phys 69:328–333PubMedCrossRef

31.

Liao S, Penney BC, Wroblewski K et al (2012) Prognostic value of metabolic tumor burden on 18F-FDG PET in nonsurgical patients with non-small cell lung cancer. Eur J Nucl Med Mol Imaging 39:27–38PubMedCrossRef

32.

Scappaticci AA, Yoo DC (2012) Recurrence of lung cancer after radiofrequency ablation detected by PET/CT and contrast enhanced CT scan. Med Health R I 95:146–148PubMed

33.

Sofocleous CT, Garg SK, Cohen P et al (2013) Ki 67 is an independent predictive biomarker of cancer specific and local recurrence-free survival after lung tumor ablation. Ann Surg Oncol 20(Suppl 3):676–683CrossRef

34.

Clasen S, Krober SM, Kosan B et al (2008) Pathomorphologic evaluation of pulmonary radiofrequency ablation: proof of cell death is characterized by DNA fragmentation and apoptotic bodies. Cancer 113:3121–3129PubMedCrossRef

35.

Jaskolka JD, Kachura JR, Hwang DM et al (2010) Pathologic assessment of radiofrequency ablation of pulmonary metastases. J Vasc Interv Radiol 21:1689–1696PubMedCrossRef

36.

Ryan ER, Sofocleous CT, Schoder H et al (2013) Split-dose technique for FDG PET/CT-guided percutaneous ablation: a method to facilitate lesion targeting and to provide immediate assessment of treatment effectiveness. Radiology 268:288–295PubMedCentralPubMedCrossRef

37.

Erinjeri JP, Thomas CT, Samoilia A et al (2013) Image-guided thermal ablation of tumors increases the plasma level of interleukin-6 and interleukin-10. J Vasc Interv Radiol 24(8):1105–1112PubMedCentralPubMedCrossRef

Title: Microwave Ablation in Combination with Chemotherapy for the Treatment of Advanced Non-Small Cell Lung Cancer
Authors: Zhigang Wei
Xin Ye
Xia Yang
Aimin Zheng
Guanghui Huang
Wenhong Li
Xiang Ni
Jiao Wang
Xiaoying Han
Publication date: 01-02-2015
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 1/2015
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-014-0895-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Microwave Ablation in Combination with Chemotherapy for the Treatment of Advanced Non-Small Cell Lung Cancer

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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