210 - Pulmonary Function After Thermal Ablation vs. Stereotactic Body Radiation Therapy for Lung Metastases: A Systematic Review and Meta-Analysis

Tuesday, April 14, 2026

3:27 PM - 3:36 PM ET

Presenting Author(s)

David-Dimitris Chlorogiannis, MD

Research Scholar
Brigham and Women's Hospital, Harvard Medical School, United States

Author/Co-author(s)

Vasileios Balomenos, MD

Radiology Resident
Attikon University General Hospital, Greece
Ornella Moschovaki-Zeiger, MD

INTERVENTIONAL RADIOLOGY TRAINEE
"ATTIKON" UNIVERSITY GENERAL HOSPITAL, Greece
AG

Athanasios Giannakis, MD

Radiology Consultant
2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Greece
NA

Nikolaos Achilleas Arkoudis, MD, PhD

Radiology Consultant
"ATTIKON" University General Hospital of Athens, Greece
GV

Georgios Velonakis, MD, PhD

Assistant Professor of Radiology
"ATTIKON" University General Hospital of Athens, Greece
Dimitrios Filippiadis, MD, PhD (he/him/his)

Professor of Interventional Radiology
2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Greece

Purpose: Stereotactic body radiation therapy (SBRT) has been reported to impact pulmonary function more significantly than percutaneous thermal ablation (TA) in patients treated for lung tumors. We performed a systematic review and meta-analysis to compare pulmonary function test (PFT) changes following TA versus SBRT in patients with primary or oligometastatic lung disease.

Materials and Methods: Following PRISMA guidelines, PubMed, Embase, and Cochrane Library were searched for studies reporting pre- and post-treatment PFTs in patients undergoing TA or SBRT. Eligible studies reported changes in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), or diffusing capacity for carbon monoxide (DLCO). Pooled estimates were calculated using a random-effects model with the DerSimonian and Laird method.

Results: Twelve studies published between 2008 and 2022 met inclusion criteria (n=759; TA: 179, SBRT: 580). SBRT was associated with a mean FVC reduction of 4.0% (95% CI, −0.6 to 8.6, p=0.16) versus 0.1% (95% CI, −2.3 to 2.2, p=0.74) for TA (p=0.12). Mean FEV1 decreased by 9.0% (95% CI, 5.8 to 12.1, p< 0.001) after SBRT, compared to 0.3% (95% CI, −2.5 to 3.2, p=0.80) after TA (p< 0.001). Mean DLCO reduction was 16.9% (95% CI, 12.5 to 21.3, p< 0.01) after SBRT versus 1.3% (95% CI, −9.9 to 12.5, p=0.99) after TA (p=0.01).

Conclusion: Compared to TA, SBRT results in significantly greater reductions in FEV1 and DLCO, whereas changes in FVC are not statistically different. TA may therefore better preserve pulmonary function in patients with limited respiratory reserve.