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Erschienen in: Journal of Cancer Research and Clinical Oncology 11/2014

01.11.2014 | Original Article – Clinical Oncology

A phase II study of radiofrequency ablation therapy for thoracic malignancies with evaluation by FDG-PET

verfasst von: Mitsunori Higuchi, Hiroshi Honjo, Takeshi Shigihara, Fumio Shishido, Hiroyuki Suzuki, Mitsukazu Gotoh

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 11/2014

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Abstract

Purpose

Computed tomography (CT)-guided radiofrequency ablation (RFA) is safe and effective for patients with unresectable primary, recurrent, or metastatic thoracic malignancies. Several studies have shown the benefit of employing 18-fluoro-deoxyglucose positron-emission tomography (FDG-PET) to follow thoracic malignancies treated with RFA. In this prospective study, we show the safety and therapeutic efficacy of RFA and the utility of FDG-PET as tool for early detection of local recurrence.

Methods

Twenty patients were enrolled in this study, and 24 lesions were ablated. Seven lesions were primary lung cancer, and 17 lesions were recurrent tumors or metastases from extrathoracic sites. Tumor size was in the range of 0.4–3.3 cm in diameter (mean: 1.5 cm). CT and FDG-PET scans were scheduled 7–14 days and 3–6 months after RFA treatment.

Results

There were 17 adverse events (70.8 %) in 24 ablations included 13 pneumothoraces, two cases of chest pain, and two episodes of fever. With a median follow-up of 35.9 months (range 1–62 months), the overall 2-year survival rate was 84.2 %. Local recurrence occurred at four sites (2-year local control rate was 74.3 %). The FDG-PET results 7–14 days after RFA did not predict recurrence, whereas positive findings 3–6 months after RFA significantly correlated with local recurrence (p = 0.0016).

Conclusions

We confirmed the effectiveness of RFA for unresectable primary and secondary thoracic malignancies. FDG-PET analysis 3–6 months after ablation is a useful tool to assess local control.
Literatur
Zurück zum Zitat Abe Y, Matsuzawa T, Fujiwara T, Itoh M, Fukuda H, Yamaguchi K, Kubota K, Hatazawa J, Tada M, Ido T, Watanuki S (1990) Clinical assessment of therapeutic effects on cancer using 18F-2-fluoro-2-deoxy-d-glucose and positron emission tomography: preliminary study of lung cancer. Int J Radiat Oncol Biol Phys 19:1005–1010PubMedCrossRef Abe Y, Matsuzawa T, Fujiwara T, Itoh M, Fukuda H, Yamaguchi K, Kubota K, Hatazawa J, Tada M, Ido T, Watanuki S (1990) Clinical assessment of therapeutic effects on cancer using 18F-2-fluoro-2-deoxy-d-glucose and positron emission tomography: preliminary study of lung cancer. Int J Radiat Oncol Biol Phys 19:1005–1010PubMedCrossRef
Zurück zum Zitat Akeboshi M, Yamakado K, Nakatsuka A, Hataji O, Taguchi O, Takao M, Takeda K (2004) Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol 15:463–470PubMedCrossRef Akeboshi M, Yamakado K, Nakatsuka A, Hataji O, Taguchi O, Takao M, Takeda K (2004) Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol 15:463–470PubMedCrossRef
Zurück zum Zitat Akhurst T, Downey RJ, Ginsberg MS, Gonen M, Bains M, Korst R, Ginsberg RJ, Rusch VW, Larson SM (2001) An initial experience with FDG-PET in the imaging of residual disease after induction therapy for lung cancer. Ann Thorac Surg 73:259–264CrossRef Akhurst T, Downey RJ, Ginsberg MS, Gonen M, Bains M, Korst R, Ginsberg RJ, Rusch VW, Larson SM (2001) An initial experience with FDG-PET in the imaging of residual disease after induction therapy for lung cancer. Ann Thorac Surg 73:259–264CrossRef
Zurück zum Zitat Alafate A, Shinya T, Okumura Y, Sato S, Hiraki T, Ishii H, Gobara H, Kato K, Fujiwara T, Miyoshi S, Kaji M, Kanazawa S (2013) The maximum standardized uptake value is more reliable than size measurement in early follow-up to evaluate potential pulmonary malignancies following radiofrequency ablation. Acta Med Okayama 67:105–112PubMed Alafate A, Shinya T, Okumura Y, Sato S, Hiraki T, Ishii H, Gobara H, Kato K, Fujiwara T, Miyoshi S, Kaji M, Kanazawa S (2013) The maximum standardized uptake value is more reliable than size measurement in early follow-up to evaluate potential pulmonary malignancies following radiofrequency ablation. Acta Med Okayama 67:105–112PubMed
Zurück zum Zitat Ambrogi MC, Lucchi M, Dini P, Melfi F, Fontanini G, Faviana P, Fanucchi O, Mussi A (2006) Percutaneous radiofrequency ablation of lung tumours: results in the midterm. Eur J Cardiothoracic Surg 30:177–183CrossRef Ambrogi MC, Lucchi M, Dini P, Melfi F, Fontanini G, Faviana P, Fanucchi O, Mussi A (2006) Percutaneous radiofrequency ablation of lung tumours: results in the midterm. Eur J Cardiothoracic Surg 30:177–183CrossRef
Zurück zum Zitat Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 174:57–59PubMedCrossRef Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 174:57–59PubMedCrossRef
Zurück zum Zitat Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response evaluation criteria in solid tumors: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247PubMedCrossRef Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response evaluation criteria in solid tumors: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247PubMedCrossRef
Zurück zum Zitat Ettinger DS, Akerley W, Borghaei H, Chang AC, Cheney RT, Chirieac LR, D’Amico TA, Demmy TL, Govindan R, Grannis FW Jr, Grant SC, Horn L, Jahan TM, Komaki R, Kong FM, Kris MG, Krug LM, Lackner RP, Lennes IT, Loo BW Jr, Martins R, Otterson GA, Patel JD, Pinder-Schenck MC, Pisters KM, Reckamp K, Riely GJ, Rohren E, Shapiro TA, Swanson SJ, Tauer K, Wood DE, Yang SC, Gregory K, Hughes M (2013) National comprehensive cancer network (2013) Non-small cell lung cancer, version 2.2013. J Natl Compr Canc Netw, 11(6):645–653 Ettinger DS, Akerley W, Borghaei H, Chang AC, Cheney RT, Chirieac LR, D’Amico TA, Demmy TL, Govindan R, Grannis FW Jr, Grant SC, Horn L, Jahan TM, Komaki R, Kong FM, Kris MG, Krug LM, Lackner RP, Lennes IT, Loo BW Jr, Martins R, Otterson GA, Patel JD, Pinder-Schenck MC, Pisters KM, Reckamp K, Riely GJ, Rohren E, Shapiro TA, Swanson SJ, Tauer K, Wood DE, Yang SC, Gregory K, Hughes M (2013) National comprehensive cancer network (2013) Non-small cell lung cancer, version 2.2013. J Natl Compr Canc Netw, 11(6):645–653
Zurück zum Zitat Frank A, Lefkowitz D, Jaeger S, Gobar L, Sunderland J, Gupta N, Scott W, Mailliard J, Lynch H, Bishop J, Thorpe P, Dewan N (1995) Decision logic for retreatment of asymptomatic lung cancer recurrence based on positron emission tomography findings. Int J Radiat Oncol Biol Phys 32:1495–1512PubMedCrossRef Frank A, Lefkowitz D, Jaeger S, Gobar L, Sunderland J, Gupta N, Scott W, Mailliard J, Lynch H, Bishop J, Thorpe P, Dewan N (1995) Decision logic for retreatment of asymptomatic lung cancer recurrence based on positron emission tomography findings. Int J Radiat Oncol Biol Phys 32:1495–1512PubMedCrossRef
Zurück zum Zitat Grills IS, Hope AJ, Guckenberger M, Kestin LL, Werner-Wasik M, Yan D, Sonke JJ, Bissonnette JP, Wilbert J, Xiao Y, Belderbos J (2012) A collaborative analysis of stereotactic lung radiotherapy outcomes for early-stage non-small-cell lung cancer using daily online cone-beam computed tomography image-guided radiotherapy. J Thorac Oncol 7(9):1382–1393. doi:10.1097/JTO.0b013e318260e00d PubMedCrossRef Grills IS, Hope AJ, Guckenberger M, Kestin LL, Werner-Wasik M, Yan D, Sonke JJ, Bissonnette JP, Wilbert J, Xiao Y, Belderbos J (2012) A collaborative analysis of stereotactic lung radiotherapy outcomes for early-stage non-small-cell lung cancer using daily online cone-beam computed tomography image-guided radiotherapy. J Thorac Oncol 7(9):1382–1393. doi:10.​1097/​JTO.​0b013e318260e00d​ PubMedCrossRef
Zurück zum Zitat Guckenberger M, Allgäuer M, Appold S, Dieckmann K, Ernst I, Ganswindt U, Holy R, Nestle U, Nevinny-Stickel M, Semrau S, Sterzing F, Wittig A, Andratschke N (2013) Safety and efficacy of stereotactic body radiotherapy for stage I non-small-cell lung cancer in routine clinical practice: a patterns-of-care and outcome analysis. J Thorac Oncol 8(8):1050–1058PubMedCrossRef Guckenberger M, Allgäuer M, Appold S, Dieckmann K, Ernst I, Ganswindt U, Holy R, Nestle U, Nevinny-Stickel M, Semrau S, Sterzing F, Wittig A, Andratschke N (2013) Safety and efficacy of stereotactic body radiotherapy for stage I non-small-cell lung cancer in routine clinical practice: a patterns-of-care and outcome analysis. J Thorac Oncol 8(8):1050–1058PubMedCrossRef
Zurück zum Zitat Hebert ME, Lowe VJ, Hoffman JM, Patz EF, Anscher MS (1996) Positron emission tomography in the pretreatment evaluation and follow-up of non-small cell lung cancer patients treated with radiotherapy: preliminary findings. Am J Clin Oncol 19:416–421PubMedCrossRef Hebert ME, Lowe VJ, Hoffman JM, Patz EF, Anscher MS (1996) Positron emission tomography in the pretreatment evaluation and follow-up of non-small cell lung cancer patients treated with radiotherapy: preliminary findings. Am J Clin Oncol 19:416–421PubMedCrossRef
Zurück zum Zitat Herrera LJ, Fernando HC, Perry Y, Gooding WE, Buenaventura PO, Christie NA, Luketich JD (2003) Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 125:929–937PubMedCrossRef Herrera LJ, Fernando HC, Perry Y, Gooding WE, Buenaventura PO, Christie NA, Luketich JD (2003) Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 125:929–937PubMedCrossRef
Zurück zum Zitat Higaki F, Okumura Y, Sato S, Hiraki T, Gobara H, Mimura H, Akaki S, Tsuda T, Kanazawa S (2008) Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor. Ann Nucl Med 22:157–163PubMedCrossRef Higaki F, Okumura Y, Sato S, Hiraki T, Gobara H, Mimura H, Akaki S, Tsuda T, Kanazawa S (2008) Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor. Ann Nucl Med 22:157–163PubMedCrossRef
Zurück zum Zitat Kang S, Luo R, Liao W, Wu H, Zhang X, Meng Y (2004) Single group study to evaluate the feasibility and complications of radiofrequency ablation and usefulness of post treatment positron emission tomography in lung tumours. World J Surg Oncol 2:30. doi:10.1186/1477-7819-2-30 PubMedCrossRefPubMedCentral Kang S, Luo R, Liao W, Wu H, Zhang X, Meng Y (2004) Single group study to evaluate the feasibility and complications of radiofrequency ablation and usefulness of post treatment positron emission tomography in lung tumours. World J Surg Oncol 2:30. doi:10.​1186/​1477-7819-2-30 PubMedCrossRefPubMedCentral
Zurück zum Zitat Lencioni R, Crocetti L, Cioni R, Suh R, Glenn D, Regge D, Helmberger T, Gillams AR, Frilling A, Ambrogi M, Bartolozzi C, Mussi A (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicenter clinical trial (the RAPTURE study). Lancet Oncol 9:621–628PubMedCrossRef Lencioni R, Crocetti L, Cioni R, Suh R, Glenn D, Regge D, Helmberger T, Gillams AR, Frilling A, Ambrogi M, Bartolozzi C, Mussi A (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicenter clinical trial (the RAPTURE study). Lancet Oncol 9:621–628PubMedCrossRef
Zurück zum Zitat Nguyen CI, Scott WJ, Goldberg M (2006) Radiofrequency ablation of lung malignancies. Ann Thorac Surg 82:365–371PubMedCrossRef Nguyen CI, Scott WJ, Goldberg M (2006) Radiofrequency ablation of lung malignancies. Ann Thorac Surg 82:365–371PubMedCrossRef
Zurück zum Zitat Nishida T, Inoue K, Kawata Y, Izumi N, Nishiyama N, Kinoshita H, Matsuoka T, Toyoshima M (2002) Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 195:426–430PubMedCrossRef Nishida T, Inoue K, Kawata Y, Izumi N, Nishiyama N, Kinoshita H, Matsuoka T, Toyoshima M (2002) Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 195:426–430PubMedCrossRef
Zurück zum Zitat Patz EF Jr, Connolly J, Herndon J (2000) Prognostic value of thoracic FDG PET imaging after treatment for non-small cell lung cancer. AJR Am J Roentgenol 174:769–777PubMedCrossRef Patz EF Jr, Connolly J, Herndon J (2000) Prognostic value of thoracic FDG PET imaging after treatment for non-small cell lung cancer. AJR Am J Roentgenol 174:769–777PubMedCrossRef
Zurück zum Zitat Pua BB, Solomon SB (2009) Radiofrequency ablation of primary and metastatic lung cancer. Semin Ultrasound CT MR 30:113–124PubMedCrossRef Pua BB, Solomon SB (2009) Radiofrequency ablation of primary and metastatic lung cancer. Semin Ultrasound CT MR 30:113–124PubMedCrossRef
Zurück zum Zitat Rose SC, Thistlethwaite PA, Sewell PE, Vance RB (2006) Lung cancer and radiofrequency ablation. J Vasc Interv Radiol 17:927–951PubMedCrossRef Rose SC, Thistlethwaite PA, Sewell PE, Vance RB (2006) Lung cancer and radiofrequency ablation. J Vasc Interv Radiol 17:927–951PubMedCrossRef
Zurück zum Zitat Silvestri GA, Sherman C, Williams T, Leong SS, Flume P, Turrisi A (2001) Caring for the dying patient with lung cancer. Chest 122:1028–1036CrossRef Silvestri GA, Sherman C, Williams T, Leong SS, Flume P, Turrisi A (2001) Caring for the dying patient with lung cancer. Chest 122:1028–1036CrossRef
Zurück zum Zitat Simon R (1989) Optimal two-stage designs for phase II clinical trials. Control Clin Trials 10:1–10PubMedCrossRef Simon R (1989) Optimal two-stage designs for phase II clinical trials. Control Clin Trials 10:1–10PubMedCrossRef
Zurück zum Zitat Soldà F, Lodge M, Ashley S, Whitington A, Goldstraw P, Brada M (2013) Stereotactic radiotherapy (SABR) for the treatment of primary non-small cell lung cancer; systematic review and comparison with a surgical cohort. Radiother Oncol 109(1):1–7PubMedCrossRef Soldà F, Lodge M, Ashley S, Whitington A, Goldstraw P, Brada M (2013) Stereotactic radiotherapy (SABR) for the treatment of primary non-small cell lung cancer; systematic review and comparison with a surgical cohort. Radiother Oncol 109(1):1–7PubMedCrossRef
Zurück zum Zitat Vansteenkiste J, De Ruysscher D, Eberhardt WE, Lim E, Senan S, Felip E, Peters S; ESMO Guidelines Working Group (2013) Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 24 (Suppl 6):vi89–vi98 Vansteenkiste J, De Ruysscher D, Eberhardt WE, Lim E, Senan S, Felip E, Peters S; ESMO Guidelines Working Group (2013) Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 24 (Suppl 6):vi89–vi98
Zurück zum Zitat Zhu JC, Yan TD, Morris DL (2008) A systematic review of radiofrequency ablation for lung tumor. Ann Surg Oncol 15:1765–1774PubMedCrossRef Zhu JC, Yan TD, Morris DL (2008) A systematic review of radiofrequency ablation for lung tumor. Ann Surg Oncol 15:1765–1774PubMedCrossRef
Metadaten
Titel
A phase II study of radiofrequency ablation therapy for thoracic malignancies with evaluation by FDG-PET
verfasst von
Mitsunori Higuchi
Hiroshi Honjo
Takeshi Shigihara
Fumio Shishido
Hiroyuki Suzuki
Mitsukazu Gotoh
Publikationsdatum
01.11.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 11/2014
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-014-1743-y

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