The safety and efficacy of microwave ablation in the treatment of lung cancer: A clinical analysis of single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TANG Haohuan , ZHOU Qi , SUN Feihu , DING Wei , SUN Lei , WANG Weitao , XU Ping , FAN Chen ,  WANG Weidong

Department of Intervention, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, 214023, Jiangsu, P.R.China;

Corresponding author：

WANG Weidong, Email: Wdoc@sina.com

Keywords：

Microwave ablation; lung cancer; safety; efficacy; intervention therapy

DOI：

10.7507/1007-4848.202103061

Video：

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Objective To evaluate the safety and efficacy of microwave ablation (MWA) in the treatment of lung tumors.Methods The clinical data of 31 patients with lung neoplasms treated with MWA from January 2019 to August 2020 in a single center were retrospectively analyzed. There were 17 males and 14 females at an age of 63.4±10.4 years. The characteristics of the lesions, technical success rate, technical efficiency, local progression rate, adverse reactions and complications were recorded in detail.Results There were 39 target lesions with an average diameter of 20.2±10.6 mm. A total of 36 MWA procedures were completed. The initial technical success rate was 84.6% (33/39), and the technical efficiency was 92.3% (36/39). The median postprocedure hospital stay was 2.0 (2.0, 3.0) d. A total of 12.9% (4/31) of the patients had local progression, and the local control rate was 87.1%. The main adverse reactions were pain (12/36, 33.3%), cough (6/36, 16.7%), post-ablation syndrome (6/36, 16.7%) and pleural effusion (3/36, 8.3%). The main complications were pneumothorax (11/36, 30.6%), hemorrhage (8/36, 22.2%), cavitation (2/36, 5.6%) and pulmonary infection (1/36, 2.8%). The median follow-up time was 13.0 (8.0, 18.0) months. No patient died during the follow-up.Conclusion MWA is safe and effective in the treatment of lung tumors with controllable complications. Successive researches with large sample, and medium and long-term follow-ups are needed to explore the significance of combined therapies.

Citation： TANG Haohuan, ZHOU Qi, SUN Feihu, DING Wei, SUN Lei, WANG Weitao, XU Ping, FAN Chen, WANG Weidong. The safety and efficacy of microwave ablation in the treatment of lung cancer: A clinical analysis of single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(11): 1310-1314. doi: 10.7507/1007-4848.202103061 Copy

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2.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3.	Moussa AM, Ziv E, Solomon SB, et al. Microwave ablation in primary lung malignancies. Semin Intervent Radiol, 2019, 36(4): 326-333.
4.	Prud'homme C, Deschamps F, Moulin B, et al. Image-guided lung metastasis ablation: A literature review. Int J Hyperthermia, 2019, 36(2): 37-45.
5.	Lin M, Eiken P, Blackmon S. Image guided thermal ablation in lung cancer treatment. J Thorac Dis, 2020, 12(11): 7039-7047.
6.	Ye X, Fan W, Wang H, et al. Expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors (2018 edition). J Cancer Res Ther, 2018, 14(4): 730-744.
7.	Healey TT, March BT, Baird G, et al. Microwave ablation for lung neoplasms: A retrospective analysis of long-term results. J Vasc Interv Radiol, 2017, 28(2): 206-211.
8.	Kurilova I, Gonzalez-Aguirre A, Beets-Tan RG, et al. Microwave ablation in the management of colorectal cancer pulmonary metastases. Cardiovasc Intervent Radiol, 2018, 41(10): 1530-1544.
9.	Vogl TJ, Worst TS, Naguib NN, et al. Factors influencing local tumor control in patients with neoplastic pulmonary nodules treated with microwave ablation: A risk-factor analysis. AJR Am J Roentgenol, 2013, 200(3): 665-672.
10.	Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: Standardization of terminology and reporting criteria—A 10-year update. Radiology, 2014, 273(1): 241-260.
11.	Bi N, Shedden K, Zheng X, et al. Comparison of the effectiveness of radiofrequency ablation with stereotactic body radiation therapy in inoperable stage Ⅰ non-small cell lung cancer: A systemic review and pooled analysis. Int J Radiat Oncol Biol Phys, 2016, 95(5): 1378-1390.
12.	Ager BJ, Wells SM, Gruhl JD, et al. Stereotactic body radiotherapy versus percutaneous local tumor ablation for early-stage non-small cell lung cancer. Lung Cancer, 2019, 138: 6-12.
13.	Lam A, Yoshida EJ, Bui K, et al. A national cancer database analysis of radiofrequency ablation versus stereotactic body radiotherapy in early-stage non-small cell lung cancer. J Vasc Interv Radiol, 2018, 29(9): 1211-1217.
14.	Bahig H, Filion E, Vu T, et al. Severe radiation pneumonitis after lung stereotactic ablative radiation therapy in patients with interstitial lung disease. Pract Radiat Oncol, 2016, 6(5): 367-374.
15.	Frost N, Tessmer A, Schmittel A, et al. Local ablative treatment for synchronous single organ oligometastatic lung cancer—A propensity score analysis of 180 patients. Lung Cancer, 2018, 125: 164-173.
16.	Abtin F, De Baere T, Dupuy DE, et al. Updates on current role and practice of lung ablation. J Thorac Imaging, 2019, 34(4): 266-277.
17.	Yuan Z, Wang Y, Zhang J, et al. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol, 2019, 16(3): 302-314.
18.	Kodama H, Ueshima E, Gao S, et al. High power microwave ablation of normal swine lung: Impact of duration of energy delivery on adverse event and heat sink effects. Int J Hyperthermia, 2018, 34(8): 1186-1193.
19.	Nour-Eldin NA, Exner S, Al-Subhi M, et al. Ablation therapy of non-colorectal cancer lung metastases: Retrospective analysis of tumour response post-laser-induced interstitial thermotherapy (LITT), radiofrequency ablation (RFA) and microwave ablation (MWA). Int J Hyperthermia, 2017, 33(7): 820-829.
20.	Vogl TJ, Eckert R, Naguib NN, et al. Thermal ablation of colorectal lung metastases: Retrospective comparison among laser-induced thermotherapy, radiofrequency ablation, and microwave ablation. AJR Am J Roentgenol, 2016, 207(6): 1340-1349.
21.	Nelson DB, Tam AL, Mitchell KG, et al. Local recurrence after microwave ablation of lung malignancies: A systematic review. Ann Thorac Surg, 2019, 107(6): 1876-1883.
22.	Chen B, Li W, Liu Y, et al. The efficacy and complications of computed tomography guided microwave ablation in lung cancer. Ann Palliat Med, 2020, 9(5): 2760-2765.
23.	田慧, 叶欣. 微波消融治疗早期非小细胞肺癌现状. 介入放射学杂志, 2018, 27(11): 1102-1106.

1. Gao S, Li N, Wang S, et al. Lung cancer in People's Republic of China. J Thorac Oncol, 2020, 15(10): 1567-1576.
2. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3. Moussa AM, Ziv E, Solomon SB, et al. Microwave ablation in primary lung malignancies. Semin Intervent Radiol, 2019, 36(4): 326-333.
4. Prud'homme C, Deschamps F, Moulin B, et al. Image-guided lung metastasis ablation: A literature review. Int J Hyperthermia, 2019, 36(2): 37-45.
5. Lin M, Eiken P, Blackmon S. Image guided thermal ablation in lung cancer treatment. J Thorac Dis, 2020, 12(11): 7039-7047.
6. Ye X, Fan W, Wang H, et al. Expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors (2018 edition). J Cancer Res Ther, 2018, 14(4): 730-744.
7. Healey TT, March BT, Baird G, et al. Microwave ablation for lung neoplasms: A retrospective analysis of long-term results. J Vasc Interv Radiol, 2017, 28(2): 206-211.
8. Kurilova I, Gonzalez-Aguirre A, Beets-Tan RG, et al. Microwave ablation in the management of colorectal cancer pulmonary metastases. Cardiovasc Intervent Radiol, 2018, 41(10): 1530-1544.
9. Vogl TJ, Worst TS, Naguib NN, et al. Factors influencing local tumor control in patients with neoplastic pulmonary nodules treated with microwave ablation: A risk-factor analysis. AJR Am J Roentgenol, 2013, 200(3): 665-672.
10. Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: Standardization of terminology and reporting criteria—A 10-year update. Radiology, 2014, 273(1): 241-260.
11. Bi N, Shedden K, Zheng X, et al. Comparison of the effectiveness of radiofrequency ablation with stereotactic body radiation therapy in inoperable stage Ⅰ non-small cell lung cancer: A systemic review and pooled analysis. Int J Radiat Oncol Biol Phys, 2016, 95(5): 1378-1390.
12. Ager BJ, Wells SM, Gruhl JD, et al. Stereotactic body radiotherapy versus percutaneous local tumor ablation for early-stage non-small cell lung cancer. Lung Cancer, 2019, 138: 6-12.
13. Lam A, Yoshida EJ, Bui K, et al. A national cancer database analysis of radiofrequency ablation versus stereotactic body radiotherapy in early-stage non-small cell lung cancer. J Vasc Interv Radiol, 2018, 29(9): 1211-1217.
14. Bahig H, Filion E, Vu T, et al. Severe radiation pneumonitis after lung stereotactic ablative radiation therapy in patients with interstitial lung disease. Pract Radiat Oncol, 2016, 6(5): 367-374.
15. Frost N, Tessmer A, Schmittel A, et al. Local ablative treatment for synchronous single organ oligometastatic lung cancer—A propensity score analysis of 180 patients. Lung Cancer, 2018, 125: 164-173.
16. Abtin F, De Baere T, Dupuy DE, et al. Updates on current role and practice of lung ablation. J Thorac Imaging, 2019, 34(4): 266-277.
17. Yuan Z, Wang Y, Zhang J, et al. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol, 2019, 16(3): 302-314.
18. Kodama H, Ueshima E, Gao S, et al. High power microwave ablation of normal swine lung: Impact of duration of energy delivery on adverse event and heat sink effects. Int J Hyperthermia, 2018, 34(8): 1186-1193.
19. Nour-Eldin NA, Exner S, Al-Subhi M, et al. Ablation therapy of non-colorectal cancer lung metastases: Retrospective analysis of tumour response post-laser-induced interstitial thermotherapy (LITT), radiofrequency ablation (RFA) and microwave ablation (MWA). Int J Hyperthermia, 2017, 33(7): 820-829.
20. Vogl TJ, Eckert R, Naguib NN, et al. Thermal ablation of colorectal lung metastases: Retrospective comparison among laser-induced thermotherapy, radiofrequency ablation, and microwave ablation. AJR Am J Roentgenol, 2016, 207(6): 1340-1349.
21. Nelson DB, Tam AL, Mitchell KG, et al. Local recurrence after microwave ablation of lung malignancies: A systematic review. Ann Thorac Surg, 2019, 107(6): 1876-1883.
22. Chen B, Li W, Liu Y, et al. The efficacy and complications of computed tomography guided microwave ablation in lung cancer. Ann Palliat Med, 2020, 9(5): 2760-2765.
23. 田慧, 叶欣. 微波消融治疗早期非小细胞肺癌现状. 介入放射学杂志, 2018, 27(11): 1102-1106.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The safety and efficacy of microwave ablation in the treatment of lung cancer: A clinical analysis of single center

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