Systemic Therapy Plus Thermal Ablation Versus Systemic Therapy Alone for Oligometastatic Liver Metastases from Non-small Cell Lung Cancer

• Published in: Cardiovascular and interventional radiology 2020-09, Vol.43 (9), p.1285-1293
• Main Authors: Zhao, Yanqing, Zhang, Xiaowu, Zhao, He, Gong, Tao, Li, Jingui, Tsauo, Jiaywei, Li, Xiao
• Format: Article
• Language: English
• Subjects: Ablation; Ablation Techniques - methods; Antineoplastic Agents - therapeutic use; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Non-Small-Cell Lung - therapy; Cardiology; Clinical Investigation; Complications; Female; Hepatocytes; Humans; Imaging; Informed consent; Interventional Oncology; Liver; Liver Neoplasms - diagnosis; Liver Neoplasms - secondary; Liver Neoplasms - therapy; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - therapy; Male; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Non-small cell lung carcinoma; Nuclear Medicine; Progression-Free Survival; Radiology; Retrospective Studies; Small cell lung carcinoma; Survival; Therapy; Treatment Outcome; Ultrasound
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-020-02456-y

Purpose This study assessed and compared the efficacy and long-term outcomes of systemic therapy plus image-guided thermal ablation versus systemic therapy alone for oligometastatic liver metastases (LMs) from non-small cell lung cancer (NSCLC). Materials and Methods This retrospective study was approved by the institutional review board. Written informed consent was waived due to the retrospective design. From November 2012 to December 2017, 61 patients (mean age 59.0 years; 35 males) with oligometastatic LMs from NSCLC (≤ 5 metastatic lesions) who received systemic therapy with ( n  = 21, group A) or without ( n  = 40, group B) thermal ablation were analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan–Meier curves. Results The demographic and clinical characteristics were not significantly different between the groups (all P  ≥ .05). In total, 28 LMs were entirely ablated, rendering a technical success rate of 100%, without major complications. The overall 6-month response rate was significantly higher in group A than in group B [57.1% (12/21) vs. 26.3% (10/38); P  = .026]. The median PFS in group A was significantly longer than in group B [11.0 (95% CI 7.9–16.2) months vs. 5.2 (95% CI 3.7–7.9) months; P  = .001]. However, the median OS was not significantly different [27.7 (95% CI 20.6–44.4) months vs. 17.7 (95% CI 14.5–27.5) months; P  = .152]. Conclusion Systemic therapy plus thermal ablation may prolong PFS but not OS in oligometastatic LMs from NSCLC.