Skip to main content

Advertisement

SpringerLink
Log in

Advanced non small cell lung cancer: response to microwave ablation and EGFR Status

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To verify the association between EGFR status and clinical response to microwave ablation (MWA) and survival.

Methods

NSCLC patients with known EGFR status and treated with MWA in combination with chemotherapy were retrospectively enrolled in the study.

Results

A total of 61 patients were recruited. EGFR mutations were found in 28 patients (39.4 %), and were more common in women (67.7 %) and nonsmokers (74.1 %). Complete ablation was achieved in 69.7 % of patients with EGFR mutant tumours and in 82.1 % of patients with EGFR wild-type tumours (p = 0.216). The median progression-free survival (PFS) and overall survival (OS) were 8.3 months and 27.2 months in patients with an EGFR mutant tumour. The corresponding values were 5.4 months (p = 0.162) and 17.8 months (p = 0.209) in patients with an EGFR wild-type tumour. Patients with complete ablation had longer PFS (7.8 months vs. 4.2 months, p = 0.024) and OS (28.1 months vs. 12.6 months, p = 0.001) than those with incomplete ablation. Multivariate analyses also showed that response to MWA was an independent prognostic factor for OS, but EGFR status was not, and that neither response to MWA nor EGFR status was a prognostic factor for PFS.

Conclusions

The EGFR status was not related to response to MWA, and response to MWA was a predictor of survival.

Key Points

• EGFR mutations were commonly seen in women and in nonsmokers

• EGFR status had no correlation with the response to MWA, PFS and OS.

• The response to MWA could predict PFS and OS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Chen W, Zheng R, Zhang S et al (2014) Annual report on status of cancer in China, 2010. Chin J Cancer Res 26(1):48–58

    PubMed  PubMed Central  Google Scholar 

  2. Schiller JH, Harrington D, Belani CP et al (2002) Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 346:92–98

    Article  CAS  PubMed  Google Scholar 

  3. Scagliotti GV, Parikh P, von Pawel J et al (2008) Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol 26(21):3543–3551

    Article  CAS  PubMed  Google Scholar 

  4. Mok TS, Wu YL, Thongprasert S et al (2009) Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med 361:947–957

    Article  CAS  PubMed  Google Scholar 

  5. Rosell R, Moran T, Queralt C et al (2009) Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med 361:958–967

    Article  CAS  PubMed  Google Scholar 

  6. Maemondo M, Inoue A, Kobayashi K et al (2010) Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med 362:2380–2388

    Article  CAS  PubMed  Google Scholar 

  7. Mitsudomi T, Morita S, Yatabe Y et al (2010) Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial. Lancet Oncol 11:121–128

    Article  CAS  PubMed  Google Scholar 

  8. Zhou C, Wu YL, Chen G et al (2011) Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 12:735–742

    Article  CAS  PubMed  Google Scholar 

  9. Takahashi T, Sonobe M, Kobayashi M et al (2010) Clinicopathologic features of non-small-cell lung cancer with EML4-ALK fusion gene. Ann Surg Oncol 17:889–897

    Article  PubMed  Google Scholar 

  10. Kwak EL, Bang YJ, Camidge DR et al (2010) Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med 363(18):1693–1703

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Liu H, Steinke K (2013) High‐powered percutaneous microwave ablation of stage I medically inoperable non‐small cell lung cancer: a preliminary study. J Med Imaging Radiat Oncol 57(4):466–474

    Article  CAS  PubMed  Google Scholar 

  12. Lu Q, Cao W, Huang L et al (2012) CT-guided percutaneous microwave ablation of pulmonary malignancies: results in 69 cases. World J Surg Oncol 10:80

    Article  PubMed  PubMed Central  Google Scholar 

  13. Carrafiello G, Mangini M, De Bernardi I et al (2010) Microwave ablation therapy for treating primary and secondary lung tumours: technical note. Radiol Med 115(6):962–974

    Article  CAS  PubMed  Google Scholar 

  14. Wei Z, Ye X, Yang X et al (2015) Microwave ablation in combination with chemotherapy for the treatment of advanced non-small cell lung cancer. Cardiovasc Intervent Radiol 38(1):135–142

    Article  PubMed  Google Scholar 

  15. Wei Z, Ye X, Yang X et al (2015) Microwave ablation plus chemotherapy improved progression-free survival of advanced non-small cell lung cancer compared to chemotherapy alone. Med Oncol 32(2):464

    Article  PubMed  Google Scholar 

  16. Thatcher N, Chang A, Parikh P et al (2005) Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet 366:1527–1537

    Article  CAS  PubMed  Google Scholar 

  17. Gow CH, Chien CR, Chang YL et al (2008) Radiotherapy in lung adenocarcinoma with brain metastases: effects of activating epidermal growth factor receptor mutations on clinical response. Clin Cancer Res 14(1):162–168

    Article  CAS  PubMed  Google Scholar 

  18. Eichler AF, Kahle KT, Wang DL et al (2010) EGFR mutation status and survival after diagnosis of brain metastasis in nonsmall cell lung cancer. Neuro Oncol 12(11):1193–1199

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Lee HL, Chung TS, Ting LL et al (2012) EGFR mutations are associated with favorable intracranial response and progression-free survival following brain irradiation in non-small cell lung cancer patients with brain metastases. Radiat Oncol 7:181

    Article  PubMed  PubMed Central  Google Scholar 

  20. Yagishita S, Horinouchi H, Katsui Taniyama T et al (2015) Epidermal growth factor receptor mutation is associated with longer local control after definitive chemoradiotherapy in patients with stage III nonsquamous non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 91(1):140–148

    Article  CAS  PubMed  Google Scholar 

  21. Mak RH, Doran E, Muzikansky A et al (2011) Outcomes after combined modality therapy for EGFR-mutant and wild-type locally advanced NSCLC. Oncologist 16(6):886–895

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Ye X, Fan WJ, Chen JH et al (2015) Chinese expert consensus workshop report: guidelines for thermal ablation of primary and metastatic lung tumors. Thorac Cancer 6:112–121

    Article  PubMed  PubMed Central  Google Scholar 

  23. Yang JC, Wu YL, Schuler M et al (2015) Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials. Lancet Oncol 16(2):141–151

    Article  CAS  PubMed  Google Scholar 

  24. Deschamps F, Farouil G, Ternes N et al (2014) Thermal ablation techniques: a curative treatment of bone metastases in selected patients? Eur Radiol 24(8):1971–1980

    Article  CAS  PubMed  Google Scholar 

  25. Qian GJ, Wang N, Shen Q et al (2012) Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies. Eur Radiol 22(9):1983–1990

    Article  PubMed  Google Scholar 

  26. Yu J, Liang P, Yu XL et al (2015) Local tumour progression after ultrasound-guided microwave ablation of liver malignancies: risk factors analysis of 2529 tumours. Eur Radiol 25(4):1119–1126

    Article  PubMed  Google Scholar 

  27. Nour-Eldin NE, Naguib NN, Mack M et al (2011) Pulmonary hemorrhage complicating radiofrequency ablation, from mild hemoptysis to life-threatening pattern. Eur Radiol 21(1):197–204

    Article  PubMed  Google Scholar 

  28. Gillams AR, Lees WR (2008) Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol 18(4):672–677

    Article  PubMed  Google Scholar 

  29. Das AK, Sato M, Story MD et al (2006) Non-small-cell lung cancers with kinase domain mutations in the epidermal growth factor receptor are sensitive to ionizing radiation. Cancer Res 66(19):9601–9608

    Article  CAS  PubMed  Google Scholar 

  30. Das AK, Chen BP, Story MD et al (2007) Somatic mutations in the tyrosine kinase domain of epidermal growth factor receptor (EGFR) abrogate EGFR-mediated radioprotection in non-small cell lung carcinoma. Cancer Res 67(11):5267–5274

    Article  CAS  PubMed  Google Scholar 

  31. Lubner MG, Brace CL, Hinshaw JL et al (2010) Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol 21(8 Suppl):S192–S203

    Article  PubMed  PubMed Central  Google Scholar 

  32. Scappaticci AA, Yoo DC (2012) Recurrence of lung cancer after radiofrequency ablation detected by PET/CT and contrast enhanced CT scan. Med Health R I 95:146–148

    PubMed  Google Scholar 

  33. Ryan ER, Sofocleous CT, Schoder H (2013) Split-dose technique for FDG PET/CT-guided percutaneous ablation: a method to facilitate lesion targeting and to provide immediate assessment of treatment effectiveness. Radiology 268:288–295

    Article  PubMed  PubMed Central  Google Scholar 

  34. Fang S, Wang Z, Guo J et al (2014) Correlation between EGFR mutation status and response to first-line platinum-based chemotherapy in patients with advanced non-small cell lung cancer. Onco Targets Ther 7:1185–1193

    PubMed  PubMed Central  Google Scholar 

  35. Zhang Q, Dai HH, Dong HY et al (2014) EGFR mutations and clinical outcomes of chemotherapy for advanced non-small cell lung cancer: a meta-analysis. Lung Cancer 85(3):339–345

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Xin Ye. The authors declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study received funding from Shandong Province Medical and Health Science and Technology Development Projects (2014WS0346). Zhigang Wei has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. None of the study subjects or cohorts have been previously reported. This retrospective observational study was performed at one institution.

Author information

Authors and Affiliations

  1. Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwuweiqi Road, Jinan, Shandong Province, China, 250021

    Zhigang Wei, Xin Ye, Xia Yang, Guanghui Huang, Wenhong Li, Jiao Wang, Xiaoying Han, Min Meng & Yang Ni

Authors
  1. Zhigang Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xin Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xia Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guanghui Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wenhong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jiao Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xiaoying Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Min Meng
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yang Ni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xin Ye.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wei, Z., Ye, X., Yang, X. et al. Advanced non small cell lung cancer: response to microwave ablation and EGFR Status. Eur Radiol 27, 1685–1694 (2017). https://doi.org/10.1007/s00330-016-4474-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-016-4474-4

Keywords

Search

Navigation