Cryoablation of T1N0M0 non–small cell lung cancer in medically inoperable patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CHEN Zhide , ZENG Junli ,  KE Mingyao

Department of Respiratory Centre, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian 361000, P. R. China;

Corresponding author：

KE Mingyao, Email: 13860166866@126.com

Keywords：

Early-stage NSCLC; Cryoablation; Efficacy; Safety

DOI：

10.7507/1671-6205.202206038

Video：

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Objective To evaluate the clinical efficacy and complications of cryoablation for T1N0M0 non-small cell lung cancer (NSCLC).Methods The clinical data of 38 patients with T1N0M0 NSCLC who underwent CT guided percutaneous cryoablation between October 2019 and March 2021 was retrospectively analyzed. The study outcomes included technical success, the local control rate, 1-year and 2-year progression free survival rate and complications.Results All patients obtained satisfactory iceball coverage and the rate of technical success was 100%. The median follow-up was 14.9 (6.3 - 25.5) months. During the follow-up, 11 patients achieved completed remission, four cases suffered local progression, the local control rate was 89.5%. 1-year progression free survival rate was 96.7%, and 2-year progression free survival rate was 87.9%. The comparison of progression free survival between the T1a-b and T1c was conducted, but no significant difference was detected (P=0.35). There was no death happened during follow-up. The intraoperative complications were pneumothorax and alveolar hemorrhage, and the postoperative complications were exacerbation of cough and pneumothorax. All complications were mild and controllable.Conclusion CT-guided percutaneous cryoablation is clinically feasible, effective and safe therapeutic method for inoperable T1N0M0 NSCLC.

Citation： CHEN Zhide, ZENG Junli, KE Mingyao. Cryoablation of T1N0M0 non–small cell lung cancer in medically inoperable patients. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(10): 710-714. doi: 10.7507/1671-6205.202206038 Copy

1.	Siegel RL, Miller KD, Fuchs HE, et al. Cancer Statistics. 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
2.	Zheng RS, Zhang SW, Zeng HM, et al. Cancer incidence and mortality in China, 2016. J Natl Cancer Cent, 2022, 2(1): 1-9.
3.	Mazzone PJ. Preoperative evaluation of the lung cancer resection candidate. Expert Rev Respir Med, 2010, 4: 97-113.
4.	Alzubaidi SJ, Liou H, Saini G, et al. Percutaneous image-guided ablation of lung tumors. J Clin Med, 2021, 10(24): 5783.
5.	Palussière J, Cazayus M, Cousin S, et al. Is there a role for percutaneous ablation for early stage lung cancer? What is the evidence?. Curr Oncol Rep, 2021, 23: 81.
6.	de Baere T, Tselikas L, Catena V, et al. Percutaneous thermal ablation of primary lung cancer. Diagn Interv Imaging, 2016, 97(10): 1019-1024.
7.	叶欣, 范卫君, 王忠敏, 等. 热消融治疗肺部亚实性结节专家共识(2021年版). 中国肺癌杂志, 2021, 24(5): 305-322.
8.	NCCN Clinical Practice Guidelines in Oncology: Non-small cell lung cancer (version 4, 2021)[EB/OL]. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf.
9.	Howington JA, Blum MG, Chang AC, et al. Treatment of Stage Ⅰ and Ⅱ Non-Small Cell Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2013, 143(5): e278S-e313S.
10.	Quirk MT, Lee S, Murali N, et al. Alternatives to surgery for early-stage non-small cell lung cancer: thermal ablation. Clin Chest Med, 2020, 41(2): 197-210.
11.	Ye X, Fan WJ, 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.
12.	Dupuy DE, Fernando HC, Hillman S, et al. Radiofrequency ablation of stage IA non-small cell lung cancer in medically inoperable patients: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial. Cancer, 2015, 121(19): 3491-3498.
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. e1.
14.	Bhatia S, Pereira K, Mohan P, et al. Radiofrequency ablation in primary non-small cell lung cancer: What a radiologist needs to know. Indian J Radiol Imaging, 2016, 26(1): 81-91.
15.	Chu KF, Dupuy DE. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat Rev Cancer, 2014, 14: 199-208.
16.	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.
17.	Macchi M, Belfiore MP, Floridi C, et al. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol, 2017, 34: 96.
18.	Inoue M, Nakatsuka S, Jinzaki M. Cryoablation of early-stage primary lung cancer. Biomed Res Int 2014, 2014: 521691.
19.	Zhang YS, Niu LZ, Zhan K, et al. Percutaneous imaging-guided cryoablation for lung cancer. J Thorac Dis, 2016, 8(Suppl 9): S705-S709.
20.	魏颖恬, 肖越勇. 影像学引导肺癌冷冻消融治疗专家共识2018版. 中国介入影像与治疗学, 2018, 15(5): 259-263.
21.	刘丽, 邵天朋, 曹建民, 等. 氩氦刀冷冻消融治疗孤立性肺结节的临床观察. 临床肿瘤学杂志, 2014, 19(12): 1128-1131.
22.	Moore W, Talati R, Bhattacharji P, et al. Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol, 2015, 26(3): 312-319.
23.	Venturini M, Cariati M, Marra P, et al. CIRSE Standards of Practice on Thermal Ablation of Primary and Secondary Lung Tumours. Cardiovasc Intervent Radiol, 2020, 43: 667-683.
24.	Yang X, Ye X, Huang GH, et al. Repeated percutaneous microwave ablation for local recurrence of inoperable Stage I nonsmall cell lung cancer. J Cancer Res Ther, 2017, 13(4): 683-688.
25.	McDevitt JL, Mouli SK, Nemcek AA, et al. 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.
26.	Mahnken AH, König AM, Figiel JH. Current technique and application of percutaneous cryotherapy. Rofo, 2018, 190(9): 836-846.
27.	Pusceddu C, Sotgia B, Fele RM, et al. CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: a preliminary experience. Eur J Radiol, 2013, 82: e246-253.
28.	Nomori H, Yamazaki I, Shiraishi A, et al. Cryoablation for T1N0M0 non-small cell lung cancer using liquid nitrogen. Eur J Radiol, 2020, 133: 109334.
29.	Ito N, Nakatsuka S, Inoue M, et al. Computed tomographic appearance of lung tumors treated with percutaneous cryoablation. J Vasc Interv Radiol, 2012, 23: 1043-1052.
30.	Bojarski JD, Dupuy DE, Mayo-Smith WW. CT imaging findings of pulmonary neoplasms after treatment with radiofrequency ablation: results in 32 tumors. AJR Am J Roentgenol, 2005, 185: 466-471.
31.	Dupuy DE. Image-guided thermal ablation of lung malignancies. Radiology, 2011, 260(3): 633-655.
32.	Zhang X, Tian JL, Zhao L, et al. CT-guided conformal cryoablation for peripheral NSCLC: initial experience. Eur J Radiol, 2012, 81(11): 3354-3362.

1. Siegel RL, Miller KD, Fuchs HE, et al. Cancer Statistics. 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
2. Zheng RS, Zhang SW, Zeng HM, et al. Cancer incidence and mortality in China, 2016. J Natl Cancer Cent, 2022, 2(1): 1-9.
3. Mazzone PJ. Preoperative evaluation of the lung cancer resection candidate. Expert Rev Respir Med, 2010, 4: 97-113.
4. Alzubaidi SJ, Liou H, Saini G, et al. Percutaneous image-guided ablation of lung tumors. J Clin Med, 2021, 10(24): 5783.
5. Palussière J, Cazayus M, Cousin S, et al. Is there a role for percutaneous ablation for early stage lung cancer? What is the evidence?. Curr Oncol Rep, 2021, 23: 81.
6. de Baere T, Tselikas L, Catena V, et al. Percutaneous thermal ablation of primary lung cancer. Diagn Interv Imaging, 2016, 97(10): 1019-1024.
7. 叶欣, 范卫君, 王忠敏, 等. 热消融治疗肺部亚实性结节专家共识(2021年版). 中国肺癌杂志, 2021, 24(5): 305-322.
8. NCCN Clinical Practice Guidelines in Oncology: Non-small cell lung cancer (version 4, 2021)[EB/OL]. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf.
9. Howington JA, Blum MG, Chang AC, et al. Treatment of Stage Ⅰ and Ⅱ Non-Small Cell Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2013, 143(5): e278S-e313S.
10. Quirk MT, Lee S, Murali N, et al. Alternatives to surgery for early-stage non-small cell lung cancer: thermal ablation. Clin Chest Med, 2020, 41(2): 197-210.
11. Ye X, Fan WJ, 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.
12. Dupuy DE, Fernando HC, Hillman S, et al. Radiofrequency ablation of stage IA non-small cell lung cancer in medically inoperable patients: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial. Cancer, 2015, 121(19): 3491-3498.
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. e1.
14. Bhatia S, Pereira K, Mohan P, et al. Radiofrequency ablation in primary non-small cell lung cancer: What a radiologist needs to know. Indian J Radiol Imaging, 2016, 26(1): 81-91.
15. Chu KF, Dupuy DE. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat Rev Cancer, 2014, 14: 199-208.
16. 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.
17. Macchi M, Belfiore MP, Floridi C, et al. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol, 2017, 34: 96.
18. Inoue M, Nakatsuka S, Jinzaki M. Cryoablation of early-stage primary lung cancer. Biomed Res Int 2014, 2014: 521691.
19. Zhang YS, Niu LZ, Zhan K, et al. Percutaneous imaging-guided cryoablation for lung cancer. J Thorac Dis, 2016, 8(Suppl 9): S705-S709.
20. 魏颖恬, 肖越勇. 影像学引导肺癌冷冻消融治疗专家共识2018版. 中国介入影像与治疗学, 2018, 15(5): 259-263.
21. 刘丽, 邵天朋, 曹建民, 等. 氩氦刀冷冻消融治疗孤立性肺结节的临床观察. 临床肿瘤学杂志, 2014, 19(12): 1128-1131.
22. Moore W, Talati R, Bhattacharji P, et al. Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol, 2015, 26(3): 312-319.
23. Venturini M, Cariati M, Marra P, et al. CIRSE Standards of Practice on Thermal Ablation of Primary and Secondary Lung Tumours. Cardiovasc Intervent Radiol, 2020, 43: 667-683.
24. Yang X, Ye X, Huang GH, et al. Repeated percutaneous microwave ablation for local recurrence of inoperable Stage I nonsmall cell lung cancer. J Cancer Res Ther, 2017, 13(4): 683-688.
25. McDevitt JL, Mouli SK, Nemcek AA, et al. 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.
26. Mahnken AH, König AM, Figiel JH. Current technique and application of percutaneous cryotherapy. Rofo, 2018, 190(9): 836-846.
27. Pusceddu C, Sotgia B, Fele RM, et al. CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: a preliminary experience. Eur J Radiol, 2013, 82: e246-253.
28. Nomori H, Yamazaki I, Shiraishi A, et al. Cryoablation for T1N0M0 non-small cell lung cancer using liquid nitrogen. Eur J Radiol, 2020, 133: 109334.
29. Ito N, Nakatsuka S, Inoue M, et al. Computed tomographic appearance of lung tumors treated with percutaneous cryoablation. J Vasc Interv Radiol, 2012, 23: 1043-1052.
30. Bojarski JD, Dupuy DE, Mayo-Smith WW. CT imaging findings of pulmonary neoplasms after treatment with radiofrequency ablation: results in 32 tumors. AJR Am J Roentgenol, 2005, 185: 466-471.
31. Dupuy DE. Image-guided thermal ablation of lung malignancies. Radiology, 2011, 260(3): 633-655.
32. Zhang X, Tian JL, Zhao L, et al. CT-guided conformal cryoablation for peripheral NSCLC: initial experience. Eur J Radiol, 2012, 81(11): 3354-3362.

Chinese Journal of Respiratory and Critical Care Medicine

Cryoablation of T1N0M0 non–small cell lung cancer in medically inoperable patients

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