دورية أكاديمية
Ablation of Stage I-II Non-Small Cell Lung Cancer in Patients With Interstitial Lung Disease: A Multicenter Retrospective Study.
| العنوان: | Ablation of Stage I-II Non-Small Cell Lung Cancer in Patients With Interstitial Lung Disease: A Multicenter Retrospective Study. |
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| المؤلفون: | Fintelmann FJ; Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114., Graur A; Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114.; Department of Radiology, Ludwig-Maximilians-University, Munich, Germany., Oueidat K; Department of Diagnostic Imaging, Lifespan Health System, Providence, RI.; Department of Diagnostic Imaging, Warren Alpert Medical School, Brown University, Providence, RI., Simon J; Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114., Barnes JMH; Department of Diagnostic Imaging, Lifespan Health System, Providence, RI.; Department of Diagnostic Imaging, Warren Alpert Medical School, Brown University, Providence, RI., McDermott S; Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114., Genshaft SJ; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA., Healey TT; Department of Diagnostic Imaging, Lifespan Health System, Providence, RI.; Department of Diagnostic Imaging, Warren Alpert Medical School, Brown University, Providence, RI., Suh RD; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA., Maxwell AWP; Department of Diagnostic Imaging, Lifespan Health System, Providence, RI.; Department of Diagnostic Imaging, Warren Alpert Medical School, Brown University, Providence, RI., Abtin F; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA. |
| المصدر: | AJR. American journal of roentgenology [AJR Am J Roentgenol] 2024 Feb; Vol. 222 (2), pp. e2330300. Date of Electronic Publication: 2023 Nov 15. |
| نوع المنشور: | Multicenter Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Roentgen Ray Society Country of Publication: United States NLM ID: 7708173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1546-3141 (Electronic) Linking ISSN: 0361803X NLM ISO Abbreviation: AJR Am J Roentgenol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2004-> : Leesburg, VA : American Roentgen Ray Society Original Publication: Springfield, Ill., Thomas. |
| مواضيع طبية MeSH: | Carcinoma, Non-Small-Cell Lung*/complications , Carcinoma, Non-Small-Cell Lung*/diagnostic imaging , Carcinoma, Non-Small-Cell Lung*/surgery , Lung Neoplasms*/complications , Lung Neoplasms*/diagnostic imaging , Lung Neoplasms*/surgery , Lung Diseases, Interstitial*/complications , Lung Diseases, Interstitial*/diagnostic imaging , Lung Diseases, Interstitial*/surgery, Male ; Humans ; Female ; Aged ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | BACKGROUND. Treatment options for patients with interstitial lung disease (ILD) who develop stage I-II non-small cell lung cancer (NSCLC) are severely limited, given that surgical resection, radiation, and systemic therapy are associated with significant morbidity and mortality. OBJECTIVE. The aim of this study was to evaluate the safety and efficacy of percutaneous ablation of stage I-II NSCLC in patients with ILD. METHODS. This retrospective study included patients with ILD and stage I-II NSCLC treated with percutaneous ablation in three health systems between October 2004 and February 2023. At each site, a single thoracic radiologist, blinded to clinical outcomes, reviewed preprocedural chest CT examinations for the presence and type of ILD according to 2018 criteria proposed by the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society. The primary outcome was 90-day major (grade ≥ 3) adverse events, based on Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Secondary outcomes were hospital length of stay (HLOS), local tumor control, and overall survival (OS). RESULTS. The study included 33 patients (19 men, 14 women; median age, 78 years; 16 patients with Eastern Cooperative Oncology Group performance status ≤ 1) with ILD who underwent 42 percutaneous ablation sessions (21 cryoablations, 11 radiofrequency ablations, 10 microwave ablations) of 43 NSCLC tumors ((median tumor size, 1.6 cm; IQR, 1.4-2.5 cm; range, 0.7-5.4 cm; 37 stage I, six stage II). The extent of lung fibrosis was 20% or less in 24 patients; 17 patients had imaging findings of definite or probable usual interstitial pneumonia. The 90-day major adverse event rate was 14% (6/42), including one CTCAE grade 4 event. No acute ILD exacerbation or death occurred within 90 days after ablation. The median HLOS was 1 day (IQR, 0-2 days). Median imaging follow-up for local tumor control was 17 months (IQR, 11-32 months). Median imaging or clinical follow-up for OS was 16 months (IQR, 6-26 months). Local tumor control and OS were 78% and 77%, respectively, at 1 year and 73% and 46% at 2 years. CONCLUSION. Percutaneous ablation appears to be a safe and effective treatment option for stage I-II NSCLC in the setting of ILD after multidisciplinary selection. CLINICAL IMPACT. Patients with ILD and stage I-II NSCLC should be considered for percutaneous ablation given that they are frequently ineligible for surgical resection, radiation, and systemic therapy. |
| التعليقات: | Comment in: AJR Am J Roentgenol. 2023 Nov 29;:. (PMID: 38019475) |
| فهرسة مساهمة: | Keywords: interstitial lung disease; lung fibrosis; multicenter; non–small cell lung cancer; percutaneous ablation |
| تواريخ الأحداث: | Date Created: 20231115 Date Completed: 20240307 Latest Revision: 20240311 |
| رمز التحديث: | 20240312 |
| DOI: | 10.2214/AJR.23.30300 |
| PMID: | 37966037 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1546-3141 |
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| DOI: | 10.2214/AJR.23.30300 |