Safety and Efficacy of Image-Guided Ablative Therapies in the Salvage Context for Patients with Recurrent NSCLC following definitive SBRT

Tuesday, April 1, 2025

4:03 PM – 4:12 PM CT

Location: Music City Center, 208 AB

Presenting Author(s)

Michelle Mai

Medical Student
Warren Alpert Medical School of Brown University, Providence, RI 02901, United States

Author/Co-author(s)

HK

Hyeonseon Kim, MD

Doctor / Research
Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA, United States
Abdifatah Omar

Medical Student
Warren Alpert Medical School of Brown University, Providence, RI 02901, United States
JA

Jacob Abraham, BS

Medical Student
Warren Alpert Medical School of Brown University, Providence, RI 02901, United States
MB

Michelle Bae, BS

Medical Student
Warren Alpert Medical School of Brown University, Providence, RI 02901, United States
SG

Sonia Giyanani, DO

Resident
Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA, United States
AM

Aaron WP Maxwell, MD

Director of Vascular and Interventional Oncology
Alpert Medical School, Brown University, United States
DK

Daehee Kim, MD

Assistant Professor
Rhode Island Hospital; Alpert Medical School Brown University, United States

Purpose:

To assess the safety and efficacy of salvage image-guided thermal ablation (IGTA) after definitive stereotactic body radiation therapy (SBRT) for patients with recurrent NSCLC.

Materials and Methods: Between February 2000 and November 2023, 40 patients with recurrent NSCLC following definitive SBRT and were treated with salvage IGTA, including microwave ablation (MWA) and cryoablation. Statistical analysis was performed to evaluate their oncologic characteristics and post-ablation outcomes Overall survival (OS) and progression free survival (PFS) were calculated using Kaplan-Meier function estimates. Complication rates and procedural related death were identified.

Results: 40 patients were analyzed in this observational study with a mean age of 72.23 ± 8.61. All patients were diagnosed with recurrent NSCLC after definitive SBRT. Total number of tumors treated was 49, average tumor size was 2.30 ± 1.89 cm, and the most common location was the right upper lobe, found in 17 cases (42.5%). The 1-year progression-free survival (PFS) was 83.9% (95% CI: 71.5%–98.3%), and the 1-year overall survival (OS) was 68.3% (95% CI: 54.3%–86.0%). Post-ablation complications occurred in 12 patients, with no procedure-related deaths. The most common complications were pneumothorax (8 patients), pleural effusion (3 patients), and hemoptysis (1 patient).

Conclusion: This study demonstrates that IGTAs is an effective and safe salvage treatment for controlling locally recurrent NSCLC, particularly in patients who have exhausted the option of further definitive SBRT.