立体定向体外放射治疗后复发患者的非小细胞肺癌经皮冷冻消融术

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS CardioVascular and Interventional Radiology Pub Date : 2025-03-11 DOI:10.1007/s00270-025-04002-0
Adam G Fish, Henry S Park, Elizabeth Knight, Christin A Knowlton, David C Madoff
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Percutaneous Cryoablation of Non-small Cell Lung Cancer in Patients with Recurrence After Stereotactic Body Radiation Therapy.

Purpose: Evaluate safety and efficacy of lung cancer cryoablation in patients with stereotactic body radiation therapy (SBRT) recurrence.

Materials and methods: Between 9/2018 and 11/2023, all patients with non-small cell lung cancer (NSCLC) treated with lung cryoablation after SBRT recurrence were retrospectively identified. Histories of smoking, COPD, post-procedural pneumothorax, adverse events requiring immediate post-procedural hospitalization, and initiation/worsening of home oxygen requirements 3-6 months later were obtained. Technical success was defined as ability to envelope the targeted tumor with an ice-ball without premature cessation of the cryoablation protocol. Outcome measures included local control, local progression-free survival, and overall survival at 6 months, 1 year, 2 years, and 3 years.

Results: 29 patients with NSCLC recurrence after SBRT underwent percutaneous cryoablation with 35 treatment sessions. Mean lesion size and standard deviation was 2.8 ± 1.5 cm (Range, 1.0-7.4 cm). Pneumothorax and hospitalization rates were 44.4% (16/36) and 36.1% (14/36). The mean number of ablation probes was 2.5 ± 1.5 (Range, 1-6). Twenty-six patients had COPD (92.9%), of which 3.8% (1/26) had new or worsened home oxygen requirements. All (36/36) cryoablations achieved technical success. Local control, local progression-free survival, and overall survival were 100%/92.9%/92.9% at 6 months, 76.2%/70.8%/92.9% at 1 year, 64.9%/60.3%/62.3% at 2 years, and 31.5%/22.6%/35.4% at 3 years.

Conclusion: Percutaneous cryoablation of non-small cell lung cancer may be a safe and effective treatment alternative for recurrence after SBRT without worsening pulmonary function.

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来源期刊
CiteScore
5.50
自引率
13.80%
发文量
306
审稿时长
3-8 weeks
期刊介绍: CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.
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