Percutaneous Cryoablation of Lung Tumors in Patients With Recurrence After Stereotactic Body Radiation Therapy

With IRB approval, patients treated with lung cryoablation after SBRT recurrence, including all tumor types, were retrospectively identified. Histories of smoking, COPD, post-procedural pneumothorax/hospitalization, and initiation/worsening of home oxygen requirements at 3- to 6-month follow-up, were obtained. Endpoints included local tumor control on Chest CT and/or PET CT at 6-months and 1 to 3 years, and 6-month to 3-year survival.

Results:

Between 9/2018 and 11/2023, 38 patients with recurrence after SBRT (28 non-small cell lung cancer and 9 metastatic disease) underwent percutaneous cryoablation with 45 treatment sessions. Lesion size was 2.6 +/- 1.4 cm (Range, 1.0-7.4 cm). Pneumothorax and hospitalization rates were 42.2% (19/45) and 35.6% (16/45). The mean number of ablation probes was 2.3 +/- 1.4 (Range, 1-6). Twenty-nine patients had COPD (76.3%) of which 3.5% (1/29) had new or worsened home oxygen requirements. 44/45 (97.8%) cryoablations achieved technical success. Local control, local progression-free survival, and overall survival were 100%/91.8%/91.8% at 6 months; 74.4%/68.3%/91.8% at 1 year; 60.5%/55.6%/67.5% at 2 years, and 34.0%/25.0%/38.0% at 3 years. For NSCLC, local control, local progression-free survival, and overall survival were at 100%/92.9%/92.9% at 6 months; 76.2%/70.8%/92.9% at 1 year; 64.9%/60.3%/62.3% at 2 years, and 31.5%/22.6%/35.4% at 3 years.

Conclusion: Percutaneous cryoablation of lung tumors may be a safe and effective treatment alternative for recurrence after SBRT without worsening pulmonary function.