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Purpose <p>Evaluate safety and efficacy of lung cancer cryoablation in patients with stereotactic body radiation therapy (SBRT) recurrence.</p> Materials and Methods <p>Between 9/2018 and 11/2023, all patients with non-small cell lung cancer (NSCLC) treated with lung cryoablation after SBRT recurrence were retrospectively identified. Histories of smoking, COPD, post-procedural pneumothorax, adverse events requiring immediate post-procedural hospitalization, and initiation/worsening of home oxygen requirements 3–6&#xa0;months later were obtained. Technical success was defined as ability to envelope the targeted tumor with an ice-ball without premature cessation of the cryoablation protocol. Outcome measures included local control, local progression-free survival, and overall survival at 6&#xa0;months, 1&#xa0;year, 2&#xa0;years, and 3&#xa0;years.</p> Results <p>29 patients with NSCLC recurrence after SBRT underwent percutaneous cryoablation with 35 treatment sessions. Mean lesion size and standard deviation was 2.8 ± 1.5&#xa0;cm (Range, 1.0–7.4&#xa0;cm). Pneumothorax and hospitalization rates were 44.4% (16/36) and 36.1% (14/36). The mean number of ablation probes was 2.5 ± 1.5 (Range, 1–6). Twenty-six patients had COPD (92.9%), of which 3.8% (1/26) had new or worsened home oxygen requirements. All (36/36) cryoablations achieved technical success. Local control, local progression-free survival, and overall survival were 100%/92.9%/92.9% at 6&#xa0;months, 76.2%/70.8%/92.9% at 1&#xa0;year, 64.9%/60.3%/62.3% at 2&#xa0;years, and 31.5%/22.6%/35.4% at 3&#xa0;years.</p> Conclusion <p>Percutaneous cryoablation of non-small cell lung cancer may be a safe and effective treatment alternative for recurrence after SBRT without worsening pulmonary function.</p> Graphic Abstract <p></p>

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Percutaneous Cryoablation of Non-small Cell Lung Cancer in Patients with Recurrence After Stereotactic Body Radiation Therapy

  • 期刊论文

  • 发表日期：

    2025年3月11日

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  • Adam G. Fish,
  • Henry S. Park,
  • Elizabeth Knight,
  • Christin A. Knowlton,
  • David C. Madoff

摘要

Purpose

Evaluate safety and efficacy of lung cancer cryoablation in patients with stereotactic body radiation therapy (SBRT) recurrence.

Materials and Methods

Between 9/2018 and 11/2023, all patients with non-small cell lung cancer (NSCLC) treated with lung cryoablation after SBRT recurrence were retrospectively identified. Histories of smoking, COPD, post-procedural pneumothorax, adverse events requiring immediate post-procedural hospitalization, and initiation/worsening of home oxygen requirements 3–6 months later were obtained. Technical success was defined as ability to envelope the targeted tumor with an ice-ball without premature cessation of the cryoablation protocol. Outcome measures included local control, local progression-free survival, and overall survival at 6 months, 1 year, 2 years, and 3 years.

Results

29 patients with NSCLC recurrence after SBRT underwent percutaneous cryoablation with 35 treatment sessions. Mean lesion size and standard deviation was 2.8 ± 1.5 cm (Range, 1.0–7.4 cm). Pneumothorax and hospitalization rates were 44.4% (16/36) and 36.1% (14/36). The mean number of ablation probes was 2.5 ± 1.5 (Range, 1–6). Twenty-six patients had COPD (92.9%), of which 3.8% (1/26) had new or worsened home oxygen requirements. All (36/36) cryoablations achieved technical success. Local control, local progression-free survival, and overall survival were 100%/92.9%/92.9% at 6 months, 76.2%/70.8%/92.9% at 1 year, 64.9%/60.3%/62.3% at 2 years, and 31.5%/22.6%/35.4% at 3 years.

Conclusion

Percutaneous cryoablation of non-small cell lung cancer may be a safe and effective treatment alternative for recurrence after SBRT without worsening pulmonary function.

Graphic Abstract