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经皮消融术在早期肺癌治疗中是否具有作用?证据是什么?

Is There a Role for Percutaneous Ablation for Early Stage Lung Cancer? What Is the Evidence?

作者信息

Palussière J, Cazayus M, Cousin S, Cabart M, Chomy F, Catena V, Buy X

机构信息

Imaging Department, Institut Bergonié, 229 cours de l'Argonne, 33076, Bordeaux, France.

Oncology Department, Institut Bergonié, Bordeaux, France.

出版信息

Curr Oncol Rep. 2021 May 5;23(7):81. doi: 10.1007/s11912-021-01072-4.

Abstract

PURPOSE OF REVIEW

For patients with early stage non-small-cell lung cancer (NSCLC), thermal ablation (TA) has become in the least two decades an option of treatment used worldwide for patients with comorbidities who are not surgical candidates. Here, we review data published with different TA techniques: radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation. This paper reviews also the comparison that has been made between TA and stereotactic radiotherapy (SBRT).

RECENT FINDINGS

A majority of retrospective studies, the absence of comparative studies, and the variety of techniques make difficult to get evident data. Nevertheless, these stand-alone techniques have demonstrated local efficacy for tumors less than 3 cm and good tolerance on fragile patients. Many recent reviews and database analyses show that outcomes after TA (mainly RFA and MWA) are comparable to SBRT in terms of survival rates. For patients who are unfit for surgery, TA has demonstrated interesting results for safety, benefits in overall survival, and acceptable local control.

摘要

综述目的

对于早期非小细胞肺癌(NSCLC)患者,在过去至少二十年中,热消融(TA)已成为全球范围内针对不适合手术的合并症患者的一种治疗选择。在此,我们回顾了采用不同TA技术(射频消融(RFA)、微波消融(MWA)和冷冻消融)发表的数据。本文还回顾了TA与立体定向放射治疗(SBRT)之间的比较。

最新发现

大多数回顾性研究、缺乏对照研究以及技术的多样性使得难以获得明确的数据。然而,这些独立技术已证明对小于3 cm的肿瘤具有局部疗效,并且对体弱患者耐受性良好。许多近期的综述和数据库分析表明,TA(主要是RFA和MWA)后的生存率与SBRT相当。对于不适合手术的患者,TA在安全性、总生存获益和可接受的局部控制方面已显示出令人感兴趣的结果。

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