Value of ablation therapy in the treatment of lung metastases

Abstract

Tumor metastases are the basic biological characteristics of malignant tumors, and the lungs are the second most prominent metastatic organs in which these develop after the liver. Currently, with the rapid development of ablation technology, ablation therapy as a local treatment is playing an increasingly important role in the treatment of lung metastases. Whether alone or in combination with other treatments, ablation therapy has achieved good therapeutic effects for the treatment of partial lung metastases. This article briefly summarizes the results of current and previous ablation treatments for lung metastases, and focuses on the value of ablation therapy for different kinds of lung metastases.

Keywords: Ablation therapy; bone and soft tissue sarcoma; colorectal cancer; lung metastases; renal cancer.

Figure 1

Ablation treatment of lung metastases from colorectal cancer. A 62‐year‐old man displayed left lung metastasis on computed tomography (CT) scans, after rectal adenocarcinoma surgery and seven‐course systemic chemotherapy. The patient received microwave ablation for the lung metastasis under CT‐guidance. No tumor recurrence was found during 11 months of follow‐up. (a) Chest CT scans: lung metastases (red arrows) were found in the superior segment of left lower lobe near the pleural. (b) CT‐guided microwave ablation of lung metastases. (c) Immediate chest CT scans after ablation: the periphery of the ablation lesion showed ground glass changes (red arrow). (d) Chest CT reviews one month after ablation: the ablation lesions showed mixed density changes (red arrow). (e,f) Chest CT reviews three months after ablation: ablation lesions showed substantial alteration without enhancement (red arrow; [e]: pulmonary window; [f]: mediastinal window). (g) Chest CT reviews 11 months after ablation: ablation lesions had significantly shrunk and no tumor recurrence was found.

Figure 2

Ablation of lung metastases from sarcoma. A 56‐year‐old man displayed lung metastases on computed tomography (CT) scan four years after left nasal sarcoma resection. The patient received microwave ablation for the lung metastasis under CT‐guidance. No tumor recurrence was found during five months of follow‐up. (a). Chest CT scans shows lung metastases (red arrows) in left lung. (b) CT‐guided microwave ablation of lung metastases. (c) Immediate chest CT scans after first ablation: the ablation lesion showed patchy changes. (d) Chest CT reviews three months after ablation: the ablation lesion became a fibrotic streak. (e) Chest CT reviews five months after ablation: the fibrotic streak had significantly shrunk and no tumor recurrence was found.

Figure 3

Ablation of lung metastases from renal cancer. A 51‐year‐old man with lung metastases from renal cancer received laparoscopic resection of left renal cell carcinoma in April 2010. The patient was administered sorafenib after surgery, but the lung metastases progressed. He received microwave ablation for the lung metastasis under CT‐guidance. No tumor recurrence was found during two months of follow‐up. (a) Chest computed tomography (CT) scans showed multiple metastases in the left superior lung. (b) CT‐guided microwave ablation of lung metastases. (c) Immediate chest CT scans after ablation: the periphery of the ablation lesion showed ground glass changes. (d,e) Chest CT reviews two months after ablation: ablation lesions showed substantial alteration without enhancement and no tumor recurrence was found.

Figure 4

Ablation of lung metastasis from primary liver cancer. A 38‐year‐old man displayed two left lung metastases on chest computed tomography (CT) review one year after resection of primary liver cancer. The patient received microwave ablation for the lung metastasis under CT‐guidance. No tumor recurrence was found during five months of follow‐up. (a) Chest CT scans: lung metastases in the left superior and inferior lobes (red arrow). (b) CT‐guided microwave ablation of lung metastases. (c) Immediate CT scans after ablation: the periphery of the ablation lesion showed ground glass changes. (d) Chest CT reviews one month after ablation: the ablation lesion became fibrotic streaks. (e) Chest CT reviews five months after ablation: fibrotic streaks in the inferior lobe significantly shrank and the ablation lesion in superior lobe changed into a consolidation nodule. No tumor recurrence was found.