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Current Radiopharmaceuticals

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ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

Research Article

CT-guided Percutaneous Microwave Ablation Combined with Local Radiotherapy or Chemotherapy of Malignant Pulmonary Tumors

Author(s): Rongde Xu, Jingjing Chen, Daohua Chen, Xiaobo Zhang, Wei Cui, Yi Deng, Danxiong Sun, Bing Yuan* and Jing Li*

Volume 17, Issue 2, 2024

Published on: 09 January, 2024

Page: [184 - 199] Pages: 16

DOI: 10.2174/0118744710261655231214105406

open access plus

Abstract

Background and Objective: The study aimed to investigate the clinical efficacy of CT-guided microwave ablation (MWA) combined with 125I seed implantation or bronchial arterial infusion (BAI) chemotherapy in the treatment of malignant pulmonary tumors.

Methods: A total of 56 patients who underwent MWA, MWA combined with 125I particle implantation, or MWA combined with BAI chemotherapy for advanced lung cancer or metastatic lung cancer from January 2015 to June 2021 in Guangdong Provincial People’s Hospital were enrolled. Among them, 21 patients were treated with MWA (MWA), 18 with MWA combined with 125I seed implantation (MWA+125I), and 17 with MWA combined with BAI chemotherapy (MWA+BAI). The short-term outcomes, complications, Eastern Cooperative Oncology Group (ECOG) performance score (Zubrod-ECOG-WHO, ZPS), survival, and factors related to survival were compared between the three groups.

Results: The response rate of the MWA group (9.52%) was significantly lower than that of the MWA+125I group (50.00%) and MWA+BAI chemotherapy group (47.06%), and the differences were statistically significant (p < 0.05). The incidence of complications in the MWA, MWA+125I, and MWA+BAI chemotherapy groups was 47.62%, 55.56%, and 52.94%, respectively, with no significant difference (p > 0.05). Three months after the treatment, the ZPS of the MWA+125I and MWA+BAI chemotherapy groups was significantly lower than before treatment and significantly lower than that of the MWA group in the same period; the differences were statistically significant (p < 0.05). The median survival time of the MWA+125I group was 18 (9.983, 26.017) months and that of the MWA+BAI chemotherapy group was 21 (0.465, 41.535) months, both of which were higher than that of the MWA group [11 (6.686, 15.314) months]; the differences were statistically significant (p < 0.05). Cox regression analysis was performed on the factors related to survival and revealed treatment mode as a protective factor [HR = 0.433, 95% CI = (0.191, 0.984), p = 0.046]. Other factors, such as gender, age, and tumor size, did not independently affect survival.

Conclusion: CT-guided MWA combined with 125I seed implantation and MWA combined with BAI chemotherapy are safe and effective for the treatment of advanced lung cancer and metastatic lung cancer, and can control tumor progression and prolong survival time.

Keywords: CT, microwave ablation, radiotherapy, chemotherapy, malignant pulmonary tumors, BAI.

Graphical Abstract
[1]
Sung, H.; Ferlay, J.; Siegel, R.L.; Laversanne, M.; Soerjomataram, I.; Jemal, A.; Bray, F. 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.
[http://dx.doi.org/10.3322/caac.21660] [PMID: 33538338]
[2]
Oncology society of chinese medical association guideline for clinical diagnosis and treatment of lung cancer 2021 edition. Zhonghua Zhong Liu Za Zhi, 2021, 43(6), 591-621. Zhonghua Zhong Liu Za Zhi [Chinese j. oncol].
[PMID: 34289551]
[3]
Siegel, R.L.; Miller, K.D.; Fuchs, H.E.; Jemal, A. Cancer Statistics, 2021. CA Cancer J. Clin., 2021, 71(1), 7-33.
[http://dx.doi.org/10.3322/caac.21654] [PMID: 33433946]
[4]
Shi, J.F. Clinical characteristics and medical service utilization of lung cancer in China, 2005-2014: Overall design and results from a multicenter retrospective epidemiologic survey. Lung cancer, 2019, 128, 91-100.
[5]
Stella, G.M.; Kolling, S.; Benvenuti, S.; Bortolotto, C. Lungseeking metastases. Cancers, 2019, 11(7), 1010.
[http://dx.doi.org/10.3390/cancers11071010] [PMID: 31330946]
[6]
Amin, S.A.; Alam, M.; Baine, M.J The impact of stereotactic body radiation therapy on the overall survival of patients diagnosed with early-stage non-small cell lung cancer. Radiother. Oncol., 2021, 155, 254-260.
[7]
Perrodin, S.; Lachenmayer, A.; Maurer, M.; Kim-Fuchs, C.; Candinas, D.; Banz, V. Percutaneous stereotactic image-guided microwave ablation for malignant liver lesions. Sci. Rep., 2019, 9(1), 13836.
[http://dx.doi.org/10.1038/s41598-019-50159-3] [PMID: 31554853]
[8]
Calandri, M.; Gazzera, C.; Giurazza, F.; Yevich, S.; Strazzarino, G.A.; Brino, J.; Marra, P.; Contegiacomo, A.; Bargellini, I.; Cariati, M.; Fonio, P.; Veltri, A. Oligometastatic colorectal cancer management: A survey of the italian college of interventional radiology. Cardiovasc. Intervent. Radiol., 2020, 43(10), 1474-1483.
[http://dx.doi.org/10.1007/s00270-020-02516-3] [PMID: 32449016]
[9]
Moon, Y.; Choi, S.Y.; Park, J.K.; Lee, K.Y. Prognostic factors in stage IB non-small cell lung cancer according to the 8th edition of the TNM staging system after curative resection. J. Thorac. Dis., 2019, 11(12), 5352-5361.
[http://dx.doi.org/10.21037/jtd.2019.11.71] [PMID: 32030253]
[10]
Palussière, J.; Cazayus, M.; Cousin, S.; Cabart, M.; Chomy, F.; Catena, V.; Buy, X. Is there a role for percutaneous ablation for early stage lung cancer? what is the evidence? Curr. Oncol. Rep., 2021, 23(7), 81.
[http://dx.doi.org/10.1007/s11912-021-01072-4] [PMID: 33948744]
[11]
Ni, Y.; Peng, J.; Yang, X.; Wei, Z.; Zhai, B.; Chi, J.; Li, X.; Ye, X. Multicentre study of microwave ablation for pulmonary oligorecurrence after radical resection of non-small-cell lung cancer. Br. J. Cancer, 2021, 125(5), 672-678.
[http://dx.doi.org/10.1038/s41416-021-01404-y] [PMID: 34131307]
[12]
Chan, M.V.; Huo, Y.R.; Cao, C.; Ridley, L. Survival outcomes for surgical resection versus CT-guided percutaneous ablation for stage I non-small cell lung cancer (NSCLC): a systematic review and meta-analysis. Eur. Radiol., 2021, 31(7), 5421-5433.
[http://dx.doi.org/10.1007/s00330-020-07634-7] [PMID: 33449192]
[13]
Gou, Q.; Zhou, Z.; Zhao, M.; Chen, X.; Zhou, Q. Advances and challenges of local thermal ablation in non-small cell lung cancer Zhongguo Fei Ai Za Zhi, 2020, 23(2), 111-117.
[PMID: 32093455]
[14]
Delpla, A.; de Baere, T.; Varin, E.; Deschamps, F.; Roux, C.; Tselikas, L. Role of thermal ablation in colorectal cancer lung metastases. Cancers, 2021, 13(4), 908.
[http://dx.doi.org/10.3390/cancers13040908] [PMID: 33671510]
[15]
Cao, C.; Wang, D.; Tian, D.H.; Wilson-Smith, A.; Huang, J.; Rimner, A. A systematic review and meta-analysis of stereotactic body radiation therapy for colorectal pulmonary metastases. J. Thorac. Dis., 2019, 11(12), 5187-5198.
[http://dx.doi.org/10.21037/jtd.2019.12.12] [PMID: 32030236]
[16]
Clinical practice guidelines:image-guided thermal ablation of primary and metastatic lung tumors 2021 edition. Zhonghua Nei Ke Za Zhi, 2021, 60(12), 1088-1105.
[PMID: 34856683]
[17]
Wang, Y.; Zhu, L.; Lin, X. Therapeutic Effect of CT-guided 125I seed implantation on advanced lung cancer and pulmonary metastatic carcinoma Zhongguo Fei Ai Za Zhi, 2020, 23(6), 424-428.
[PMID: 32517444]
[18]
Chen, L.; Ying, X.; Zhang, D.; Lai, L.; Wu, F.; Tu, J.; Ji, J. Iodine-125 brachytherapy can prolong progression-free survival of patients with locoregional recurrence and/or residual hepatocellular carcinoma after radiofrequency ablation. Cancer Biother. Radiopharm., 2021, 36(10), 820-826.
[http://dx.doi.org/10.1089/cbr.2020.3647] [PMID: 32551979]
[19]
Li, Y.M.; Guo, R.Q.; Bie, Z.X.; Li, B.; Li, X.G. Sintilimab plus bronchial arterial infusion chemotherapy/drug-eluting embolic chemoembolization for advanced non–small cell lung cancer: A preliminary study of 10 patients. J. Vasc. Interv. Radiol., 2021, 32(12), 1679-1687.
[http://dx.doi.org/10.1016/j.jvir.2021.08.019] [PMID: 34492303]
[20]
Young, J.; Badgery-Parker, T.; Dobbins, T.; Jorgensen, M.; Gibbs, P.; Faragher, I.; Jones, I.; Currow, D. Comparison of ECOG/WHO performance status and ASA score as a measure of functional status. J. Pain Symptom Manage., 2015, 49(2), 258-264.
[http://dx.doi.org/10.1016/j.jpainsymman.2014.06.006] [PMID: 24996034]
[21]
Aras, M.; Erdil, T.Y.; Dane, F.; Gungor, S.; Ones, T.; Dede, F.; Inanir, S.; Turoglu, H.T. Comparison of WHO, RECIST 1.1, EORTC, and PERCIST criteria in the evaluation of treatment response in malignant solid tumors. Nucl. Med. Commun., 2016, 37(1), 9-15.
[http://dx.doi.org/10.1097/MNM.0000000000000401] [PMID: 26440568]
[22]
Laribi, K.; Sobh, M.; Ghez, D.; Baugier de Materre, A. Impact of age, functional status, and comorbidities on quality of life and outcomes in elderly patients with AML: review. Ann. Hematol., 2021, 100(6), 1359-1376.
[http://dx.doi.org/10.1007/s00277-020-04375-x] [PMID: 33796898]
[23]
Guirgis, F.W.; Leeuwenburgh, C.; Moldawer, L.; Ghita, G.; Black, L.P.; Henson, M.; DeVos, E.; Holden, D.; Efron, P.; Reddy, S.T.; Moore, F.A. Lipid and lipoprotein predictors of functional outcomes and long-term mortality after surgical sepsis. Ann. Intensive Care, 2021, 11(1), 82.
[http://dx.doi.org/10.1186/s13613-021-00865-x] [PMID: 34018068]
[24]
Quirk, M.T.; Lee, S.; Murali, N.; Genshaft, S.; Abtin, F.; Suh, R. Alternatives to surgery for early-stage non–small cell lung cancer. Clin. Chest Med., 2020, 41(2), 197-210.
[http://dx.doi.org/10.1016/j.ccm.2020.02.002] [PMID: 32402356]
[25]
Lin, M.; Eiken, P.; Blackmon, S. Image guided thermal ablation in lung cancer treatment. J. Thorac. Dis., 2020, 12(11), 7039-7047.
[http://dx.doi.org/10.21037/jtd-2019-cptn-08] [PMID: 33282409]
[26]
Huang, G.; Yang, X.; Li, W.; Wang, J.; Han, X.; Wei, Z.; Meng, M.; Ni, Y.; Zou, Z.; Wen, Q.; Dai, J.; Zhang, T.; Ye, X. A feasibility and safety study of computed tomography-guided percutaneous microwave ablation: A novel therapy for multiple synchronous ground-glass opacities of the lung. Int. J. Hyperthermia, 2020, 37(1), 414-422.
[http://dx.doi.org/10.1080/02656736.2020.1756467]
[27]
Jairam, V.; Park, H.S.; Decker, R.H. Local ablative therapies for oligometastatic and oligoprogressive non–small cell lung cancer. Cancer J., 2020, 26(2), 129-136.
[http://dx.doi.org/10.1097/PPO.0000000000000433] [PMID: 32205537]
[28]
Santucci, C; Carioli, G; Bertuccio, P. Progress in cancer mortality, incidence, and survival: A global overview. Eur. J. Cancer Prev., 2020, 29(5), 367-381.
[29]
Ye, X.; Fan, W.; Wang, Z.; Wang, J.; Wang, H.; Wang, J.; Wang, C.; Niu, L.; Fang, Y.; Gu, S.; Tian, H.; Liu, B.; Liu, L.; Zhong, L.; Zhuang, Y.; Chi, J.; Sun, X.; Yang, N.; Wei, Z.; Li, X.; Li, X.; Li, Y.; Li, C.; Li, Y.; Yang, X.; Yang, W.; Yang, P.; Yang, Z.; Xiao, Y.; Song, X.; Zhang, K.; Chen, S.; Chen, W.; Lin, Z.; Lin, D.; Meng, Z.; Zhao, X.; Hu, K.; Liu, C.; Liu, C.; Gu, C.; Xu, D.; Huang, Y.; Huang, G.; Peng, Z.; Dong, L.; Jiang, L.; Han, Y.; Zeng, Q.; Jin, Y.; Lei, G.; Zhai, B.; Li, H.; Pan, J. Expert consensus on thermal ablation therapy of pulmonary subsolid nodules (2021 Edition). J. Cancer Res. Ther., 2021, 17(5), 1141.
[http://dx.doi.org/10.4103/jcrt.jcrt_1485_21] [PMID: 33896152]
[30]
Ahmed, M.; Solbiati, L.; Brace, C.L.; Breen, D.J.; Callstrom, M.R.; Charboneau, J.W.; Chen, M.H.; Choi, B.I.; de Baère, T.; Dodd, G.D., III; Dupuy, D.E.; Gervais, D.A.; Gianfelice, D.; Gillams, A.R.; Lee, F.T., Jr; Leen, E.; Lencioni, R.; Littrup, P.J.; Livraghi, T.; Lu, D.S.; McGahan, J.P.; Meloni, M.F.; Nikolic, B.; Pereira, P.L.; Liang, P.; Rhim, H.; Rose, S.C.; Salem, R.; Sofocleous, C.T.; Solomon, S.B.; Soulen, M.C.; Tanaka, M.; Vogl, T.J.; Wood, B.J.; Goldberg, S.N. Image-guided tumor ablation: Standardization of terminology and reporting criteria--a 10-year update. Radiology, 2014, 273(1), 241-260.
[http://dx.doi.org/10.1148/radiol.14132958] [PMID: 24927329]
[31]
Vasilescu, D M; Phillion, A B Comprehensive stereological assessment of the human lung using multiresolution computed tomography. J. Appl. Physiol., 2020, 128(6), 1604-1616.
[32]
Chan, J.W.Y.; Lau, R.W.H.; Ngai, J.C.L.; Tsoi, C.; Chu, C.M.; Mok, T.S.K.; Ng, C.S.H. Transbronchial microwave ablation of lung nodules with electromagnetic navigation bronchoscopy guidance—a novel technique and initial experience with 30 cases. Transl. Lung Cancer Res., 2021, 10(4), 1608-1622.
[http://dx.doi.org/10.21037/tlcr-20-1231] [PMID: 34012778]
[33]
Yang, X.; Ye, X.; Lin, Z.; Jin, Y.; Zhang, K.; Dong, Y.; Yu, G.; Ren, H.; Fan, W.; Chen, J.; Lin, Q.; Huang, G.; Wei, Z.; Ni, Y.; Li, W.; Han, X.; Meng, M.; Wang, J.; Li, Y. Computed tomography-guided percutaneous microwave ablation for treatment of peripheral ground-glass opacity–Lung adenocarcinoma. J. Cancer Res. Ther., 2018, 14(4), 764-771.
[http://dx.doi.org/10.4103/jcrt.JCRT_269_18] [PMID: 29970650]
[34]
Zhang, T; Mo, Z; Duan, G Seed promotes apoptosis in non-small lung cancer cells via the p38 MAPK-MDM2-p53 signaling pathway. Front. Oncol., 2021, 11, 582511.
[35]
Zeng, Y.; Yin, M.; Zhao, Y.; Liu, Y.; Li, X.; Qi, Y.; Ma, Y.; Li, Z.; Li, C.; Wu, G. Combination of bronchial arterial infusion chemotherapy plus drug-eluting embolic transarterial chemoembolization for treatment of advanced lung cancer—a retrospective analysis of 23 patients. J. Vasc. Interv. Radiol., 2020, 31(10), 1645-1653.
[http://dx.doi.org/10.1016/j.jvir.2020.06.007] [PMID: 32951974]
[36]
Wei, Z.G.YE X. Problems and prospects of image-guided thermal ablation in the treatment of primary and metastatic lung tumors Zhonghua Nei Ke Za Zhi, 2021, 60(12), 1019-1023.
[PMID: 34856678]
[37]
Lu, M.; Yao, W.; Zhang, T.; Fan, W.; Zhong, Z.; Li, J.; Zhang, F. Feasibility and efficacy of microwave ablation combined with iodine-125 seed implantation in local control of recurrent retroperitoneal liposarcomas: Initial clinical experience. Oncologist, 2017, 22(12), 1500-1505.
[http://dx.doi.org/10.1634/theoncologist.2016-0499] [PMID: 28701568]
[38]
Gou, Q.; Wu, L.; Cui, W.; Mo, Z.; Zeng, D.; Gan, L.; He, J.; Mai, Q.; Shi, F.; Chen, M.; Sun, Z.; Liu, Y.; Wu, J.; Chen, X.; Zhuang, W.; Xu, R.; Li, W.; Cai, Q.; Zhang, J.; Chen, X.; Li, J.; Zhou, Z. Stent placement combined with intraluminal radiofrequency ablation and hepatic arterial infusion chemotherapy for advanced biliary tract cancers with biliary obstruction: A multicentre, retrospective, controlled study. Eur. Radiol., 2021, 31(8), 5851-5862.
[http://dx.doi.org/10.1007/s00330-021-07716-0] [PMID: 33585991]
[39]
Bie, Z.; Li, Y.; Li, B.; Wang, D.; Li, L.; Li, X. The efficacy of drug‐eluting beads bronchial arterial chemoembolization loaded with gemcitabine for treatment of non‐small cell lung cancer. Thorac. Cancer, 2019, 10(9), 1770-1778.
[http://dx.doi.org/10.1111/1759-7714.13139] [PMID: 31321919]
[40]
Xu, S.; Bie, Z.X.; Li, Y.M.; Li, B.; Guo, R.Q.; Li, X.G. A comparative study of cavitary and noncavitary non–small cell lung cancer patients treated with ct-guided microwave ablation. J. Vasc. Interv. Radiol., 2021, 32(8), 1170-1178.
[http://dx.doi.org/10.1016/j.jvir.2021.05.006] [PMID: 34033905]
[41]
Cahill, A.M.; Annam, A.; Baskin, K.M.; Caplin, D.; Cramer, H.R., Jr; Connolly, B.; Crowley, J.; Heran, M.; Himes, E.A.; Hogan, M.J.; Josephs, S.; Pabon-Ramos, W.; Prajapati, H.; Shivaram, G.; Towbin, R.; Vaidya, S.S. Society of interventional radiology quality improvement standards for percutaneous nephrostomy in the pediatric population. J. Vasc. Interv. Radiol., 2021, 32(1), 146-149.
[http://dx.doi.org/10.1016/j.jvir.2020.07.029] [PMID: 33388108]
[42]
Wan, Y.; Wang, X.; Zheng, N.; Shi, J. Clinical research of selective bronchial artery infusion and chemotherapy of lung cancer Zhongguo Fei Ai Za Zhi, 2003, 6(5), 378-380.
[PMID: 21306684]
[43]
Zhao, Z.; Yao, W.; Zhang, T.; Chen, S.; Fu, W.; Chen, L.; Ma, Y.; Wang, J.; Lu, M.; Jiao, D. Computed tomography-guided implantation of 125I radioactive seeds in patients with malignant airway compression induced by advanced lung cancer: effectiveness and safety in 40 patients. J. Contemp. Brachytherapy, 2020, 12(4), 343-350.
[http://dx.doi.org/10.5114/jcb.2020.98113] [PMID: 33293973]
[44]
Oken, M.M.; Creech, R.H.; Tormey, D.C.; Horton, J.; Davis, T.E.; McFadden, E.T.; Carbone, P.P. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am. J. Clin. Oncol., 1982, 5(6), 649-656.
[http://dx.doi.org/10.1097/00000421-198212000-00014] [PMID: 7165009]
[45]
Li, M.; Zhang, Y.; Zhang, X. Effects of surgery and radiofrequency ablation in the treatment of spinal metastases and analysis of the influencing factors of prognosis. Exp. Ther. Med., 2020, 19(2), 1072-1078.
[PMID: 32010271]
[46]
Yang, X.G.; Wu, G.; Li, Z.W.; Wu, H.; Sun, Y.Y.; Wen, H.H.; Xu, G.H. Efficacy for artery chemoembolization combined with radiofrequency ablation in the treatment of advanced non-small cell lung cancer Zhonghua Yi Xue Za Zhi, 2016, 96(7), 539-543.
[PMID: 26902194]
[47]
Xiang, Z.; Bai, M.; Li, G.; Zou, B.; Zhong, Z.; Gao, F.; Wu, C.; Huang, M.; Zhang, F. Safety and efficacy of 125I brachytherapy for bilateral lung recurrences from hepatocellular carcinoma after resection or ablation. J. Cancer Res. Clin. Oncol., 2019, 145(7), 1907-1916.
[http://dx.doi.org/10.1007/s00432-019-02943-x] [PMID: 31161374]
[48]
Lu, C.W.; Shao, J.; Wu, Y.G.; Wang, C.; Wu, J.H.; Lv, R.X.; Ding, M.C.; Shi, Z.C.; Mao, N.F. Which combination treatment is better for spinal metastasis: percutaneous vertebroplasty with radiofrequency ablation, 125I seed, zoledronic acid, or radiotherapy? Am. J. Ther., 2019, 26(1), e38-e44.
[http://dx.doi.org/10.1097/MJT.0000000000000449] [PMID: 29087367]
[49]
Lassandro, G.; Picchi, S.G.; Bianco, A.; Di Costanzo, G.; Coppola, A.; Ierardi, A.M.; Lassandro, F. Effectiveness and safety in radiofrequency ablation of pulmonary metastases from HCC: A five years study. Med. Oncol., 2020, 37(4), 25.
[http://dx.doi.org/10.1007/s12032-020-01352-2] [PMID: 32166529]
[50]
Koshiishi, H.; Yoshimura, T.; Okamura, T.; Tamamoto, F.; Takahashi, E.; Hayashi, N.; Koshiishi, Y. Evaluation of bronchial arterial infusion (BAI) for metastatic lung tumor from colorectal cancer Gan To Kagaku Ryoho, 2004, 31(11), 1838-1841.
[PMID: 15553732]

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