Combination of Local Ablative Techniques with Radiotherapy for Primary and Recurrent Lung Cancer: A Systematic Review.
Paolo BonomeDonato PezzullaValentina LancellottaAnna Rita ScrofaniGabriella MacchiaElena RodolfinoLuca TagliaferriGyörgy KovacsFrancesco DeodatoRoberto IezziPublished in: Cancers (2023)
In patients with early-stage or recurrent NSCLC who are unable to tolerate surgery, a benefit could derive only from a systemic therapy or another few forms of local therapy. A systematic review was performed to evaluate the feasibility and the effectiveness of radiotherapy combined with local ablative therapies in the treatment of primary and recurrent lung cancer in terms of toxicity profile and local control rate. Six studies featuring a total of 115 patients who met eligibility criteria and 119 lesions were included. Three studies evaluated lung cancer patients with a medically inoperable condition treated with image-guided local ablative therapies followed by radiotherapy: their local control rate (LC) ranged from 75% to 91.7% with only 15 patients (19.4%) reporting local recurrence after combined modality treatment. The other three studies provided a salvage option for patients with locally recurrent NSCLC after RT: the median follow-up period varied from 8.3 to 69.3 months with an LC rate ranging from 50% to 100%. The most common complications were radiation pneumonitis (9.5%) and pneumothorax (29.8%). The proposed intervention appears to be promising in terms of toxicity profile and local control rate. Further prospective studies are need to better delineate combining LTA-RT treatment benefits in this setting.
Keyphrases
- early stage
- small cell lung cancer
- locally advanced
- radiation therapy
- randomized controlled trial
- radiation induced
- systematic review
- end stage renal disease
- oxidative stress
- case control
- emergency department
- mass spectrometry
- rheumatoid arthritis
- ejection fraction
- chronic kidney disease
- mesenchymal stem cells
- coronary artery bypass
- tyrosine kinase
- prognostic factors
- advanced non small cell lung cancer
- combination therapy
- simultaneous determination
- acute coronary syndrome
- patient reported outcomes
- liquid chromatography
- atrial fibrillation
- tandem mass spectrometry