scholarly journals Cryoablation Using Liquid Nitrogen for Metastatic Lung Cancers

2021 ◽  
Author(s):  
Hiroaki Nomori ◽  
Ikuo Yamazaki ◽  
Takuya Adachi ◽  
Masaya Kanno ME
Keyword(s):  
Pulmonary Function ◽  
Liquid Nitrogen ◽  
Local Control ◽  
Tumor Size ◽  
Lung Tumors ◽  
Secondary Outcome ◽  
Lung Cancers ◽  
Metastatic Lung ◽  
Single Tumor

Abstract AimsTo identify factors that were associated with local control after cryoablation for metastatic lung tumors and to compare preserved pulmonary function according to tumor number.MethodsWe retrospectively evaluated 68 patients with 121 metastatic lung tumors that were treated with cryoablation using liquid nitrogen during 2013–2019. Primary outcome was whether local control was related with tumor size, histology, location, and distance to a vessel with a diameter of ≥3 mm. Secondary outcome was whether preserved pulmonary function varied according to number of treated tumors. ResultsMedian follow-up period was 32 months (range: 4–87 months).Histological types were carcinomas in 95 tumors and sarcoma in 26 tumors. Multivariate analysis revealed that local control was significantly associated with tumor size (p<0.001), histology (p<0.001), and distance from a vessel with a diameter of ≥3 mm (p=0.03). Among tumors with a diameter of ≥2.2 cm, poorer local control was observed for sarcomas (p<0.001) and tumors that were ≤3 mm from the vessel (p=0.009), although these relationships were not significant among tumors with a diameter of <2.2 cm (p=0.44 and p=0.16). Relative to cryoablation for a single tumor, cryoablation for multiple tumors was associated with significantly lower preservation of pulmonary function (p=0.002). ConclusionPoor local control after cryoablation was significantly associated with tumor size ≥2.2 cm, sarcoma histology, and tumors that were ≤3 mm from a vessel with a diameter of ≥3 mm. Preserved pulmonary function declined significantly with an increasing number of treated tumors.

Taming Cryoablation for Lung Tumors

2018 ◽  
Author(s):  
Anshuman Bansal ◽  
Fereidoun Abtin
Keyword(s):  
Patient Selection ◽  
Selection Criteria ◽  
Patient Positioning ◽  
Lung Tumors ◽  
Lung Cancers ◽  
Percutaneous Cryoablation ◽  
Patient Selection Criteria ◽  
Physical Principles

This chapter details the indications, uses, and techniques of using percutaneous cryoablation to treat lung tumors. The chapter reviews the role of ablative therapy for primary lung cancers as well as metastatic disease to the lung. It reviews the basic physical principles of cryoablation and the advantages of percutaneous cryoablation compared to other percutaneous heat-based ablative modalities. Patient selection criteria and post-ablation follow-up protocols are discussed. The chapter reviews procedural considerations, including choice of anesthesia, patient positioning, probe trajectory, and post-procedural recovery. It also details techniques that can be used to minimize and treat complications as well as tips for treating more challenging lesions.

scholarly journals Local Control of Metastatic Lung Tumors Treated with SBRT of 48 Gy in Four Fractions: In Comparison with Primary Lung Cancer

2009 ◽  
Vol 40 (2) ◽  
pp. 125-129 ◽  
Author(s):  
Y. Hamamoto ◽  
M. Kataoka ◽  
M. Yamashita ◽  
T. Shinkai ◽  
Y. Kubo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Local Control ◽  
Primary Lung Cancer ◽  
Lung Tumors ◽  
Metastatic Lung

scholarly journals Prognostic impact of average iodine density assessed by dual-energy spectral imaging for predicting lung tumor recurrence after stereotactic body radiotherapy

2016 ◽  
Vol 57 (4) ◽  
pp. 381-386 ◽  
Author(s):  
Masahiko Aoki ◽  
Katsumi Hirose ◽  
Mariko Sato ◽  
Hiroyoshi Akimoto ◽  
Hideo Kawaguchi ◽  
...  
Keyword(s):  
Local Control ◽  
Stereotactic Body Radiotherapy ◽  
Lung Tumor ◽  
Lung Metastases ◽  
Prognostic Significance ◽  
Lung Tumors ◽  
Dual Energy ◽  
Hypoxic Cell ◽  
Prognostic Impact ◽  
Lung Cancers

Abstract The purpose of this study was to investigate the prognostic significance of average iodine density as assessed by dual-energy computed tomography (DE-CT) for lung tumors treated with stereotactic body radiotherapy (SBRT). From March 2011 to August 2014, 93 medically inoperable patients with 74 primary lung cancers and 19 lung metastases underwent DE-CT prior to SBRT of a total dose of 45–60 Gy in 5–10 fractions. Of these 93 patients, nine patients had two lung tumors. Thus, 102 lung tumors were included in this study. DE-CT was performed for pretreatment evaluation. Regions of interest were set for the entire tumor, and average iodine density was obtained using a dedicated imaging software and evaluated with regard to local control. The median follow-up period was 23.4 months (range, 1.5–54.5 months). The median value of the average iodine density was 1.86 mg/cm 3 (range, 0.40–9.27 mg/cm 3 ). Two-year local control rates for the high and low average iodine density groups divided by the median value of the average iodine density were 96.9% and 75.7% ( P = 0.006), respectively. Tumors with lower average iodine density showed a worse prognosis, possibly reflecting a hypoxic cell population in the tumor. The average iodine density exhibited a significant impact on local control. Our preliminary results indicate that iodine density evaluated using dual-energy spectral CT may be a useful, noninvasive and quantitative assessment of radio-resistance caused by presumably hypoxic cell populations in tumors.

scholarly journals P3-051: Correlation with PET-CT/ follow up CT for primary and metastatic lung cancers treated with cryoablation

2007 ◽  
Vol 2 (8) ◽  
pp. S628
Author(s):  
Soo-Youn Ham ◽  
Sung Ho Lee ◽  
Kwang Taik Kim ◽  
Yu-Hwan Oh ◽  
Sung Bum Cho ◽  
...  
Keyword(s):  
Lung Cancers ◽  
Pet Ct ◽  
Metastatic Lung

Characteristics and outcomes of patients (pts) with metastatic KRAS mutant lung adenocarcinomas: Lung Cancer Mutation Consortium (LCMC) database.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 9021-9021 ◽  
Author(s):  
Badi Edmond El Osta ◽  
Madhusmita Behera ◽  
Sungjin Kim ◽  
Lynne D Berry ◽  
Gabriel Sica ◽  
...  
Keyword(s):  
Kras Mutation ◽  
Kras Mutations ◽  
Lung Cancers ◽  
Kras Status ◽  
Metastatic Lung ◽  
Multivariable Analyses ◽  
Baseline Characteristics ◽  
Never Smokers ◽  
Lung Adenocarcinomas

9021 Background: To better understand outcome heterogeneity in pts with KRAS mutant lung cancers, we analyzed the largest multi-institutional database of pts with metastatic KRAS mutant lung adenocarcinomas. Methods: We reviewed data of all pts who consented to LCMC between 2009-2015. Pts with known KRAS status were included in analyses. Mutation data along with co-mutations were obtained along with clinical outcomes. We evaluated baseline characteristics and association of KRAS data with overall survival (OS), calculated from date of distant metastasis to death, in a univariate and multivariable analyses. The median follow-up was 2.15 years (95% CI: 2.01-2.27). Results: 1655 (86%) of 1918 pts’ data were analyzed. Comparative characteristics are summarized in the Table. Among 450 (23%) pts with KRAS mutations: 58% female, 93% ever smokers, and median age 65 years. Main KRAS subtypes: G12C 39%, G12D and G12V were 18% each. Never smokers with KRAS mutation were more likely to have G12D subtypes (18%; p < 0.001). Pts with KRAS mutation, the median OS was 1.96 years, with 2-year OS rate of 49%. Co-mutations (1-16) were checked in all KRAS mutant pts. Co-mutations were rare (14 pts; 3%). KRAS co-mutations were associated with improved OS in multivariable analyses (HR 0.35; 95% CI: 0.13-0.97; p = 0.04), but not KRAS main subtypes / codons. Co-mutation STK-11 in particular (17 of 92 pts; 18%) was associated with poor OS in univariate (HR 2.16; 95% CI: 1.03-4.54; p = 0.04) and multivariable analyses (HR 2.31; 95% CI: 1.18-5.50; p = 0.02). Pts with KRAS mutations had a trend towards a shorter survival (median OS 1.96 vs. 2.22 years; p = 0.08) and a decreased 2-year OS when compared to KRAS wildtype [49% (95% CI: 44-54%) vs. 55% (95% CI: 52-58%)], respectively. Conclusions: KRAS mutation is a significant predictor of worse survival outcomes in pts with metastatic lung adenocarcinomas. The presence of STK-11 co-mutation was associated with especially poor OS. [Table: see text]

Pathology Issues in Thoracic Oncology: Histologic Characterization and Tissue/Plasma Genotyping May Resolve Diagnostic Dilemmas

2017 ◽  
pp. 619-629
Author(s):  
Ibiayi Dagogo-Jack ◽  
Andreas Saltos ◽  
Alice T. Shaw ◽  
Jhanelle E. Gray
Keyword(s):  
Lung Cancer ◽  
Diagnostic Algorithm ◽  
Advanced Lung Cancer ◽  
Liquid Biopsies ◽  
Lung Cancers ◽  
Primary Lung Tumors ◽  
Metastatic Lung ◽  
Mixed Histology

Lung cancer is a heterogeneous diagnosis that encompasses a spectrum of histologic and molecular subgroups. A paradigm shift favoring selection of treatment based on histologic and molecular makeup has positively affected prognosis for patients with metastatic lung cancer, with select patients experiencing durable responses to treatment. However, prognosis remains poor for the majority of patients. Furthermore, oncologists are increasingly faced with challenging dilemmas related to histopathologic and molecular characterization of tumors, both at diagnosis and during treatment. In this review, we focus on three particular challenges: (1) management of mixed histology tumors, a particularly aggressive group of lung cancers, (2) distinguishing multiple primary lung tumors from intrapulmonary metastases, and (3) incorporation of liquid biopsies into the diagnostic algorithm and subsequent follow-up of patients with advanced lung cancer. This review will summarize the existing literature and highlight the potential for molecular genotyping to help refine approaches to each of these challenges.

Radiotherapy after testis-sparing surgery for seminoma in monorchid patients: safety and efficacy

2021 ◽  
pp. 030089162199242
Author(s):  
Barbara Avuzzi ◽  
Andrea Tittarelli ◽  
Stefano Andreani ◽  
Barbara Noris Chiorda ◽  
Ettore Seregni ◽  
...  
Keyword(s):  
Germ Cell ◽  
Local Control ◽  
Tumor Size ◽  
Germ Cell Tumors ◽  
Endocrine Function ◽  
Testosterone Levels ◽  
Hormonal Function ◽  
Increased Risk

Purpose: To evaluate local control and longitudinal endocrine data in monorchid patients treated with testicular-sparing surgery and adjuvant radiotherapy (RT) for seminomatous germ-cell tumors. Methods: We searched our database established in 2009 for patients with seminoma who received testis irradiation following partial orchiectomy up to 2018. Eleven patients were identified. All had associated germ cell neoplasia in situ (GCNIS) in surrounding parenchyma. Analysis focused on local control and testosterone levels preservation after RT. We considered age, baseline (pre-RT) testosterone and luteinizing hormone (LH) levels, residual testicular volume, tumor size, and testosterone and LH levels trend over time in order to identify any association with endocrine impairment leading to hormonal replacement need. Results: After a median follow-up of 21 months, no local or distant relapses were observed and hormonal function was maintained in 54.5% of patients (6/11). No significant interactions were observed for the investigated covariates. Notably, we observed an association between higher baseline testosterone levels and a decreased risk of exogenous androgen replacement (hazard ratio [HR] 0.409, 95% confidence interval [CI] 0.161–1.039, p = 0.060), whereas tumor size was associated with an increased risk of exogenous androgen replacement (HR 1.847, 95% CI 0.940–3.627, p = 0.075). Conclusions: Radiotherapy after testicular sparing surgery is effective in preventing local disease relapse in presence of GCNIS in the medium term. This strategy allows a preservation of adequate endocrine function in about half of patients. More patients and longer follow-up are needed to confirm these findings.

Retrospective study of systemic chemotherapy in combination with consolidative stereotactic body radiation therapy (SBRT) in patients with five or fewer oligometastases from breast, colorectal, and lung cancers.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21036-e21036
Author(s):  
Alice Ulhoa-Cintra ◽  
Dulabh K. Monga ◽  
Alexander V. Kirichenko
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Systemic Chemotherapy ◽  
Stereotactic Body Radiation Therapy ◽  
Nsclc Patient ◽  
Tumor Control ◽  
Lung Cancers ◽  
Stereotactic Body Radiation ◽  
Low Toxicity

e21036 Background: The oligometastatic state is one of limited metastases, amenable to local therapies of curative potential. Stereotactic body radiation therapy (SBRT) is a non-surgical treatment with a primary goal of rapid local tumor control and low toxicity allowing prompt return to systemic therapy. Breast (BRC), colorectal (CRC) and non-small cell lung cancers (NSCLC) have oligometastases as first presentation. In these patients, consolidative SBRT offers effective local control and low toxicity, with the potential for improved survival benefit without affecting quality of life. We report our experience on such patients. Methods: 31 patients with BRC (9), CRC (16) and NSCLC (6) with ≤ 5 unresectable metastases to one to three organ sites were identified. Data were obtained from chart review. Primary end point was infield local control. Lesions with at least 6 months of radiographic follow-up were assessable. Secondary end points were toxicity and survival. Results: All patients completed SBRT to 38 lesions (≤2/patient). 29 received prior chemotherapy for metastatic disease. 14 were treated with at least 1 prior regimen and 15 at least 2 (0-8). At a median follow-up of 16 months (4-32), 22 patients (8 BRC, 10 CRC and 4 NSCLC) were assessable. At 6 months, 20 patients had infield local control and 3 demonstrated distant metastases. At 1 year, this was seen in 19 and 7 patients respectively. The most common toxicity was grade ≤2 fatigue. All BRC had infield local control at 6 months and 1 year. Among CRC, 9 had infield local control at 6 months and 7 at 1 year. 3 NSCLC patients had infield local control at 6 months and 1 year. No BRC demonstrated distant progression at 6 months; at 1 year, it was seen in 2 patients. 3 CRC had evidence of distant progression at 6 months and 1 year. 1 NSCLC patient had distant progression at 6 months and 2 at 1 year. 6 patients died from their underlying malignancy; the median survival for 5 of these patients was 20 months (5-34). Conclusions: The combination of systemic chemotherapy and consolidative SBRT is safe and effective for patients with oligometastatic disease

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