Primary and Metastatic Lung Cancer: Rationale, Indications, and Outcomes of Thermal Ablation

医学 微波消融 肺癌 烧蚀 放射科 开胸手术 肺癌的治疗 经皮 离格 外科 疾病 肾细胞癌 重症监护医学 放射治疗 肿瘤科 内科学
作者
Nariman Nezami,Fereshteh Khorshidi,Arian Mansur,Peiman Habibollahi,Juan C. Camacho
出处
期刊:Clinical Lung Cancer [Elsevier BV]
卷期号:24 (5): 389-400 被引量:5
标识
DOI:10.1016/j.cllc.2023.03.012
摘要

The widespread use of imaging as well as the efforts conducted through screening campaigns has dramatically increased the early detection rate of lung cancer. Historically, the management of lung cancer has heavily relied on surgery. However, the increased proportion of patients with comorbidities has given significance to less invasive therapeutic options like minimally invasive surgery and image-guided thermal ablation, which could precisely target the tumor without requiring general anesthesia or a thoracotomy. Thermal ablation is considered low-risk for lung tumors smaller than 3 cm that are located in peripheral lung and do not involve major blood vessels or airways. The rationale for ablative therapies relies on the fact that focused delivery of energy induces cell death and pathologic necrosis. Image-guided percutaneous thermal ablation therapies are established techniques in the local treatment of hepatic, renal, bone, thyroid and uterine lesions. In the lung, and specifically in the setting of metastatic disease, the 3 main indications for lung ablation are to serve as (1) curative intent, (2) as a strategy to achieve a chemo-holiday in oligometastatic disease, and (3) in oligoprogressive disease. Following these premises, the current paper aims to review the rationale, indications, and outcomes of thermal ablation as a form of local therapy in the treatment of primary and metastatic lung disease.
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