Microwave Ablation, Radiofrequency Ablation, Irreversible Electroporation, and Stereotactic Ablative Body Radiotherapy for Intermediate Size (3-5 cm) Unresectable Colorectal Liver Metastases: a Systematic Review and Meta-analysis.

Autor: Nieuwenhuizen S; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands., Dijkstra M; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands. m.dijkstra3@amsterdamumc.nl., Puijk RS; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands., Geboers B; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands., Ruarus AH; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands., Schouten EA; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands., Nielsen K; Department of Surgery, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands., de Vries JJJ; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands., Bruynzeel AME; Department of Radiation Oncology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands., Scheffer HJ; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands., van den Tol MP; Department of Surgery, Medisch Centrum Leewarden, Leeuwarden, the Netherlands., Haasbeek CJA; Department of Radiation Oncology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands., Meijerink MR; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Current oncology reports [Curr Oncol Rep] 2022 Jun; Vol. 24 (6), pp. 793-808. Date of Electronic Publication: 2022 Mar 17.
DOI: 10.1007/s11912-022-01248-6
Abstrakt: Purpose of Review: Based on good local control rates and an excellent safety profile, guidelines consider thermal ablation the gold standard to eliminate small unresectable colorectal liver metastases (CRLM). However, efficacy decreases exponentially with increasing tumour size. The preferred treatment for intermediate-size unresectable CRLM remains uncertain. This systematic review and meta-analysis compare safety and efficacy of local ablative treatments for unresectable intermediate-size CRLM (3-5 cm).
Recent Findings: We systematically searched for publications reporting treatment outcomes of unresectable intermediate-size CRLM treated with thermal ablation, irreversible electroporation (IRE) or stereotactic ablative body-radiotherapy (SABR). No comparative studies or randomized trials were found. Literature to assess effectiveness was limited and there was substantial heterogeneity in outcomes and study populations. Per-patient local control ranged 22-90% for all techniques; 22-89% (8 series) for thermal ablation, 44% (1 series) for IRE, and 67-90% (1 series) for SABR depending on radiation dose. Focal ablative therapy is safe and can induce long-term disease control, even for intermediate-size CRLM. Although SABR and tumuor-bracketing techniques such as IRE are suggested to be less susceptible to size, evidence to support any claims of superiority of one technique over the other is unsubstantiated by the available evidence. Future prospective comparative studies should address local-tumour-progression-free-survival, local control rate, overall survival, adverse events, and quality-of-life.
(© 2022. The Author(s).)
Databáze: MEDLINE
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