Current Management of Oligometastatic Lung Cancer and Future Perspectives: Results of Thermal Ablation as a Local Ablative Therapy
Abstract
:Simple Summary
Abstract
1. Introduction
1.1. Local Ablation Therapy for Oligometastatic Disease
1.2. Potential Advantages of Thermal Ablation over Other LAT
1.3. Indications of Thermal Ablation
2. Thermal Ablation Modalities
2.1. RFA
2.2. MWA
2.3. Cryoablation
3. Definition of Oligometastases and Rationale for Thermal Ablation
- Synchronous disease: patients that present at initial diagnosis with a limited number of metastases (mostly up to five) that are technically amenable to a radical treatment [50];
- Oligoresidual disease: patients who initially had multiple metastases and responded to systemic therapy with only limited metastases remaining, all amenable to a radical treatment [51];
- Metachronous disease (oligorecurrence): patients presenting with limited metastases after curative treatment to a locoregional disease, with an active disease now limited to the metastatic sites [52].
3.1. Adjuvant and Consolidation Therapy
3.2. Salvage Therapy after Local Recurrence
4. Materials and Methods
5. Results
5.1. Survival
5.1.1. Lung
5.1.2. Liver
5.2. Oligoprogressive Disease
5.3. Prognostic Factors
5.4. Local Efficacy and Predictors of Recurrence
5.5. Safety and Quality of Life
5.6. Comparison to Other LAT Modalities
6. Future Perspectives in the Era of Immunotherapies
7. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Ref (Year) | Study Design | No | TA | Sites Treated with TA | Indication of TA | Mean Tumor Size (Range) | Median FUP (mo) | Median PFS (mo) | Median OS (mo) |
---|---|---|---|---|---|---|---|---|---|
Lencioni (2008) [9] | Single-arm, phase II | 106 (20 NSCLC with metastases or recurrence) | RFA | Lung |
| 22 mm * (7–30) | - | - | 1 y and 2 y OS of 70% and 48% * |
Arrieta (2019) [67] | Single-arm, phase II | 37 (2 treated with TA) | RFA | - |
| - | 32.5 | 23.5 ** | NR ** |
Bauml (2019) [68] | Single-arm, phase II | 45 (1 treated with TA) | - | - |
| - | 25 | 19.1 ** | 41.6 ** |
Wei (2020) [69] | Phase III RCT | 148 (MWA+ chemo group) vs. 145 (chemo only) | MWA | Lung |
| 36 mm (10–130) | 13.1 vs. 12.4 | 10.3 vs. 4.9 | NR vs. 12.4 |
Ref (Year) | No | TA | Sites Treated with TA | Indication of TA | Mean Tumor Size (Range) | Median FUP | Median PFS | Median OS |
---|---|---|---|---|---|---|---|---|
Bang, (2012) [55] | 31 | Cryo | Lung, liver, superficial, paraaortic, adrenal, bone |
| 31 mm (NA) | Mean = 11 mo | - | 15.9 mo, 1-y OS of 53% |
Li (2013) [70] | 49 | RFA | Lung |
| 29 mm (14–50) | 19 mo | 16 weeks | 14 mo |
Ni (2020) [71] | 86 (34 treated with MWA) | MWA | Lung, liver, bone, adrenal gland, chest wall |
| 29 mm (1–56) | 36 mo | 16.7 mo vs. 12.9 mo | 34.8 mo vs. 22.7 mo |
Kodama (2012) [72] | 44 | RFA | Lung |
| 17 mm (6–40) | Mean = 28.6 mo | - | 1 y, 3 y, 5 y OS of 97.7%, 72.9%, 55.7% |
Schoellnast (2012) [73] | 33 | RFA | Lung |
| 28 mm (10–75) | 24 mo | 8 mo | 21 mo |
Cheng (2016) [74] | 12 | RFA, MWA | Lung |
| 34 mm (17–61) | Mean = 19 mo | - | 35 mo |
Jiang (2019) [75] | 64 OM (5 treated with TA) | RFA | Liver |
| - | - | 12.9 mo ** vs. 7.9 mo | 36.8 mo ** vs. 21.3 mo |
Zhao (2020) [76] | 61 (21 treated with TA) | RFA, MWA | Liver |
| 24.4 mm (NA) | 36.4 mo | 11.0 mo vs. 5.2 mo | 27.7 mo vs. 17.7 mo |
Ref (Year) | No | TA | Sites Treated with TA | Indication of TA | Mean Tumor Size (Range) | Median PFS1 (mo) | Median PFS2 (mo) | Median OS (mo) | PFS Definitions |
---|---|---|---|---|---|---|---|---|---|
Yu (2013) [7] | 18 (2 treated with TA) | RFA | Lung |
| - | 10 * | 22 * | 41 * |
|
Jiang (2019) [75] | 71 OP (8 treated with TA) | RFA | Liver |
| - | - | 13.9 * vs. 9.2 | 28.3 * vs. 17.1 |
|
Ni (2019) [80] | 71 | RFA, MWA | Lung, liver, adrenal, pleura, lymph node |
| 33 mm (10–105) | 11.8 | 10.0 | 26.4 |
|
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Ghosn, M.; Solomon, S.B. Current Management of Oligometastatic Lung Cancer and Future Perspectives: Results of Thermal Ablation as a Local Ablative Therapy. Cancers 2021, 13, 5202. https://doi.org/10.3390/cancers13205202
Ghosn M, Solomon SB. Current Management of Oligometastatic Lung Cancer and Future Perspectives: Results of Thermal Ablation as a Local Ablative Therapy. Cancers. 2021; 13(20):5202. https://doi.org/10.3390/cancers13205202
Chicago/Turabian StyleGhosn, Mario, and Stephen B. Solomon. 2021. "Current Management of Oligometastatic Lung Cancer and Future Perspectives: Results of Thermal Ablation as a Local Ablative Therapy" Cancers 13, no. 20: 5202. https://doi.org/10.3390/cancers13205202