Ghosn Mario, Solomon Stephen B
Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Cancers (Basel). 2021 Oct 16;13(20):5202. doi: 10.3390/cancers13205202.
A growing body of evidence shows improved overall survival and progression-free survival after thermal ablation in non-small cell lung carcinoma (NSCLC) patients with a limited number of metastases, combined with chemotherapy or tyrosine kinase inhibitors or after local recurrence. Radiofrequency ablation and microwave ablation are the most evaluated modalities, and target tumor size <3 cm (and preferably <2 cm) is a key factor of technical success and efficacy. Although thermal ablation offers some advantages over surgery and radiotherapy in terms of repeatability, safety, and quality of life, optimal management of these patients requires a multidisciplinary approach, and further randomized controlled trials are required to help refine patient selection criteria. In this article, we present a comprehensive review of available thermal ablation modalities and recent results supporting their use in oligometastatic and oligoprogressive NSCLC disease along with their potential future implications in the emerging field of immunotherapy.
越来越多的证据表明,对于转移灶数量有限的非小细胞肺癌(NSCLC)患者,在联合化疗或酪氨酸激酶抑制剂治疗后,或在局部复发后进行热消融,可改善总生存期和无进展生存期。射频消融和微波消融是评估最多的方式,目标肿瘤大小<3 cm(最好<2 cm)是技术成功和疗效的关键因素。尽管热消融在可重复性、安全性和生活质量方面比手术和放疗具有一些优势,但对这些患者的最佳管理需要多学科方法,并且需要进一步的随机对照试验来帮助完善患者选择标准。在本文中,我们对现有的热消融方式以及支持其在寡转移和寡进展性NSCLC疾病中应用的最新结果进行了全面综述,以及它们在新兴的免疫治疗领域的潜在未来影响。