Ключевые слова
Как цитировать
Аннотация
Лечение злокачественных новообразований легкого — актуальная проблема современной онкологии. Рак легкого занимает первое место в структуре онкологической заболеваемости и смертности, метастатическое поражение легких встречается у 20-45 % больных онкологическими заболеваниями. Несмотря на достигнутый прогресс в комплексном лечении злокачественных новообразований, существует необходимость в разработке новых методик, поскольку существующие методы либо не могут быть применены в определенных случаях, либо не обеспечивают достаточной эффективности. В данном обзоре литературы представлены основные исследования, посвященные криоаблации в лечении первичных и метастатических опухолей легкого, как в целях достижения локального контроля над заболеванием, так и с паллиативной и симптоматической целью, методологическим особенностям, наблюдаемым и ожидаемым осложнениям, методам их купирования, избранным вопросам криоиммунологии. Исходя из представленных исследований можно сделать вывод о безопасности, возможности применения метода как с целью достижения циторедукции, так и с паллиативной целью, особенно у пациентов, которым противопоказаны оперативное лечение и лучевая терапия. Представленные криоиммунологические исследования являются перспективным направлением для дальнейшего изучения комбинированного воздействия низкотемпературных методик и современных иммуноонкологических препаратов. Ограничением исследований, представленных в данном обзоре, является низкая степень доказательности, отсутствие прямого сравнения с другими методами локального воздействия, что не позволяет достоверно судить об эффективности данной технологии и онкологических результатах ее применения.
Библиографические ссылки
Bray F., Laversanne M., Sung H., et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024; 74(3): 229-63.-DOI: https://doi.org/10.3322/caac.21834.
Zhao X., Wen X., Wei W., et al. Clinical characteristics and prognoses of patients treated surgically for metastatic lung tumors. Oncotarget. 2017; 8(28): 46491-7.-DOI: https://doi.org/10.18632/oncotarget.14822.
Hayman J., Naidoo J., Ettinger D.S. Lung metastases. Abeloff’s Clinical Oncology. 2020; 831-845.e6.-DOI: https://doi.org/10.1016/b978-0-323-47674-4.00057-8.
van Dorp M., Trimbos C., Schreurs W.H., et al. Colorectal pulmonary metastases: pulmonary metastasectomy or stereotactic radiotherapy? Cancers. 2023; 15(21): 5186.-DOI: https://doi.org/10.3390/cancers15215186.
Brunelli A., Gooseman M.R., Pompili C. Evaluation of risk for thoracic surgery. Surg Oncol Clin N Am. 2020; 29(4) :497-508.- URL: Evaluation of Risk for Thoracic Surgery - PubMed.
Kong F.M. (Spring), Moiseenko V., Zhao J., et al. Organs at risk considerations for thoracic stereotactic body radiation therapy: What is safe for lung parenchyma? Int J Radiat Oncol Biol Phys. 2021; 110(1): 172-87.-DOI: https://doi.org/10.1016/j.ijrobp.2018.11.028.
Maiwand M.O., Asimakopoulos G. Cryosurgery for lung cancer: Clinical results and technical aspects. Technol Cancer Res Treat. 2004; 3(2): 143-50.-DOI: https://doi.org/10.1177/153303460400300207.
Beamis J.F., Becker H.D., Cavaliere S., et al. ERS/ATS statement on interventional pulmonology. Eur Respir J. 2002; 19(2): 356-73.-DOI: https://doi.org/10.1183/09031936.02.00204602.
Noppen M., Meysman M., van Herreweghe R., et al. Bronchoscopic cryotherapy: preliminary experience Acta Clin Belg. 2001; 56(2): 73-7.-DOI: https://doi.org/10.1179/acb.2001.013.
Deygas N., Froudarakis M., Ozenne G., Vergnon J.M. Cryotherapy in early superficial bronchogenic carcinoma. Chest. 2001; 120(1): 26-31.-DOI: https://doi.org/10.1378/chest.120.1.26.
Bartlett E.C., Rahman S., Ridge C.A. Percutaneous image-guided thermal ablation of lung cancer: What is the evidence? Lung Cancer. 2023; 176: 14-23.-DOI: https://doi.org/10.1016/j.lungcan.2022.12.010.
Palussière J., Catena V., Lagarde P., et al. Primary tumors of the lung: should we consider thermal ablation as a valid therapeutic option? Int J Hyperthermia. 2019; 36(2): 46-52.-DOI: https://doi.org/10.1080/02656736.2019.1647351.
Sonntag P.D., Hinshaw J.L., Lubner M.G., et al. Thermal ablation of lung tumors. Surg Oncol Clin N Am. 2011; 20(2): 369-87.-DOI: https://doi.org/10.1016/j.soc.2010.11.008.
Nomori H., Yamazaki I., Shiraishi A., et al. Cryoablation for T1N0M0 non-small cell lung cancer using liquid nitrogen. Eur J Radiol. 2020; 133: 109334.-DOI: https://doi.org/10.1016/j.ejrad.2020.109334.
Yashiro H., Nakatsuka S., Inoue M., et al. Factors affecting local progression after percutaneous cryoablation of lung tumors. J Vasc Interv Radiol. 2013; 24(6): 813-21.-DOI: https://doi.org/10.1016/j.jvir.2012.12.026.
McDevitt J.L., Mouli S.K., Nemcek A.A., et al. Percutaneous cryoablation for the treatment of primary and metastatic lung tumors: Identification of risk factors for recurrence and major complications. J Vasc Interv Radiol. 2016; 27(9): 1371-9.-DOI: https://doi.org/10.1016/j.jvir.2016.04.005.
Lyons G.R., Askin G., Pua B.B. Clinical outcomes after pulmonary cryoablation with the use of a triple freeze protocol. J Vasc Interv Radiol. 2018; 29(5): 714-21.-DOI: https://doi.org/10.1016/j.jvir.2017.12.029.
Moore W., Talati R., Bhattacharji P., Bilfinger T. Five-year survival after cryoablation of stage i non–small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol. 2015; 26(3): 312-9.-DOI: https://doi.org/10.1016/j.jvir.2014.12.006.
Yamauchi Y., Izumi Y., Hashimoto K., et al. Percutaneous cryoablation for the treatment of medically inoperable stage i non-small cell lung cancer. PLoS ONE. 2012; 7(3): e33223.-DOI: https://doi.org/10.1371/journal.pone.0033223.-URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.003322.
Zemlyak A., Moore W.H., Bilfinger T.V. Comparison of survival after sublobar resections and ablative therapies for stage i non−small cell lung cancer. J Am Coll Surg. 2010; 211(1): 68-72.-DOI: https://doi.org/10.1016/j.jamcollsurg.2010.03.020.
Королев, Д.Г., Каганов, О.И., Кривощеков, Е.П., et al. Роль радиочастотной абляции в лечение первичного и метастатического рака легкого. Известия Самарского научного центра Российской академии наук. 2015; 17(2-3): 562-6.- EDN: UKKYKP. [Korolev D.G., Kaganov O.I., Krivoshchekov E.P., et al. The role of radiofrequency ablation in the treatment of primary and metastatic lung cancer. Proceedings of the Samara Scientific Center of the Russian Academy of Sciences. 2015; 17(2-3): 562-6.-EDN: UKKYKP (In Rus)].
Li H.W., Long Y.J., Yan G.W., et al. Microwave ablation vs. cryoablation for treatment of primary and metastatic pulmonary malignant tumors. Mol Clin Oncol. 2022; 16(3): 62.-DOI: https://doi.org/10.3892/mco.2022.2495.
Das S., Huang Y., Li B., et al. Comparing cryoablation and microwave ablation for the treatment of patients with stage IIIB/IV non small cell lung cancer. Oncol Lett. 2019; 19(1); 1031-41.-DOI: https://doi.org/10.3892/ol.2019.11149.
Xu Z., Wang X., Ke H., Lyu G. Cryoablation is superior to radiofrequency ablation for the treatment of non-small cell lung cancer: A meta-analysis. Cryobiology. 2023; 112: 104560.-DOI: https://doi.org/ 10.1016/j.cryobiol.2023.104560.
Callstrom M.R., Woodrum D.A., Nichols F.C., et al. Multicenter study of metastatic lung tumors targeted by interventional cryoablation evaluation (SOLSTICE). J Thorac Oncol. 2020; 15(7): 1200-9.-DOI: https://doi.org/10.1016/j.jtho.2020.02.022.
de Baère T., Woodrum D., Tselikas L., et al. The ECLIPSE study: Efficacy of cryoablation on metastatic lung tumors with a 5-year follow-up. J Thorac Oncol. 2021; 16(11): 1840-9.-DOI: https://doi.org/10.1016/j.jtho.2021.07.021.
Alexander E., Petre N., Offin M., et al. Abstract no. 13 safety and efficacy of percutaneous cryoablation for primary and metastatic intrathoracic, pleural based tumors. J Vasc Interv Radiol. 2023; 34(3): S8.-DOI: https://doi.org/10.1016/j.jvir.2022.12.052.
Petrella F., Danuzzo F., Sibilia M., et al. Colorectal cancer pulmonary metastasectomy: When, why and how. Cancers. 2024; 16(7): 1408.-DOI: https://doi.org/10.3390/cancers16071408.
Hasegawa T., Takaki H., Kodama H., et al. Three-year survival rate after radiofrequency ablation for surgically resectable colorectal lung metastases: A prospective multicenter study. Radiology. 2020; 294(3): 686-95.-DOI: https://doi.org/10.1148/radiol.2020191272.
Каганов О.И. Оценка результативности хирургического лечения колоректальных метастазов в легкие с применением метода радиочастотной аблации. Общественное здоровье и здравоохранение. 2009; 3: 72-8.-EDN: MVKCUJ. [Kaganov O.I. Evaluation of the effectiveness of surgical treatment of colorectal lung metastases using radiofrequency ablation. Public Health and Healthcare. 2009; 3: 72-8.-EDN: MVKCUJ (in Rus)].
Han Y., Yan X., Zhi W., et al. Long-term outcome following microwave ablation of lung metastases from colorectal cancer. Front Oncol. 2022; 12: 943715.-DOI: https://doi.org/10.3389/fonc.2022.943715.
Wang F. Ming, Luo R., Tian J. Ming, et al. CT-guided percutaneous cryoablation for lung metastasis of colorectal cancer: A case series. Technol Cancer Res Treat. 2023; 22: e15330338231201508.-DOI: https://doi.org/10.1177/15330338231201508.
Yamauchi Y., Izumi Y., Kawamura M., et al. Percutaneous cryoablation of pulmonary metastases from colorectal cancer. PLoS ONE. 2011; 6(11): e27086.-DOI: https://doi.org/10.1371/journal.pone.0027086.-URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0027086.
Garcia-Exposito N., Ramos R., Navarro-Perez V., et al. Stereotactic body radiotherapy versus surgery for lung metastases from colorectal cancer: Single-institution results. Cancers. 2023; 15(4): 1195.-DOI: https://doi.org/10.3390/cancers15041195.
Gupta R., van de Ven T., Pyati S. Post-thoracotomy pain: Current strategies for prevention and treatment. Drugs. 2020; 80(16): 1677-84.-DOI: https://doi.org/10.1007/s40265-020-01390-0.
Khanmohammadi S., Noroozi A., Yekaninejad M.S., Rezaei N. Cryoablation for the palliation of painful bone metastasis: A systematic review. Cardiovasc Intervent Radiol. 2023; 46(11): 1469-82.-DOI: https://doi.org/10.1007/s00270-022-03356-z.
Буровик И.А., Прохоров Г.Г., Багненко С.С., et al. Пункционная чрескожная стереотаксическая криоаблация в купировании боли при метастатическом поражении костей. Онкологический журнал: лучевая диагностика, лучевая терапия. 2022; 5(1): 65–73.-DOI: https://doi.org/10.37174/2587-7593-2022-5-1-65-73. [Burovik I.A., Prokhorov G.G., Bagnenko S.S., et al. Punctural percutaneous image-guided cryoablation for pain relief in bone metastases. Journal of Oncology: Diagnostic Radiology and Radiotherapy. 2022; 5(1): 65-73.-DOI: https://doi.org/10.37174/2587-7593-2022-5-1-65-73 (In Rus)].
Li F., Wang W., Li L., et al. An effective therapy to painful bone metastases: Cryoablation combined with zoledronic acid. Pathol Oncol Res. 2014; 20(4): 885-91.-DOI: https://doi.org/10.1007/s12253-014-9769-7.
di Staso M., Gravina G.L., Zugaro L., et al. Treatment of solitary painful osseous metastases with radiotherapy, cryoablation or combined therapy: Propensity matching analysis in 175 patients. PLOS ONE. 2015; 10(6): e0129021.-DOI: https://doi.org/10.1371/journal.pone.0129021.-URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129021.
Thacker P.G., Callstrom M.R., Curry T.B., et al. Palliation of painful metastatic disease involving bone with imaging-guided treatment: Comparison of patients’ immediate response to radiofrequency ablation and cryoablation. Am J Roentgenol. 2011; 197(2): 510-5.-DOI: https://doi.org/10.2214/AJR.10.6029.
Fintelmann F.J., Braun P., Mirzan S.H., et al. Percutaneous cryoablation: Safety and efficacy for pain palliation of metastases to pleura and chest wall. J Vasc Interv Radiol. 2020; 31(2): 294-300.-DOI: https://doi.org/10.1016/j.jvir.2019.09.013.
Буровик И.А., Прохоров Г.Г., Багненко С.С., Васильев А.В. Пункционная чрескожная криоабляция при метастатическом поражении ребер. Креативная хирургия и онкология. 2022; 12(3): 187-92.-DOI: https://doi.org/10.24060/2076-3093-2022-12-3-187-192. [Burovik I.A., Prokhorov G.G., Bagnenko S.S., Vasilev A.V. Percutaneous puncture cryoablation in patients with rib metastatic lesions. Creative Surgery and Oncology. 2022; 12(3): 187-192.-DOI: https://doi.org/10.24060/2076-3093-2022-12-3-187-192 (In Rus)].
Chen S.Y., Mack S.J., Stein J.E., et al. Intercostal nerve cryoablation is associated with reduced opioid use in pediatric oncology patients. J Surg Res. 2023; 283: 377-84.-DOI: https://doi.org/10.1016/j.jss.2022.11.004.
Yasin J., Thimmappa N., Kaifi J.T., et al. CT-guided cryoablation for post-thoracotomy pain syndrome: a retrospective analysis. Diagn Interv Radiol. 2020; 26(1): 53-7.-DOI: https://doi.org/10.5152/dir.2019.19179.
Marasso A., Gallo E., Massaglia G.M., et al. Cryosurgery in bronchoscopic treatment of tracheobronchial stenosis. Chest. 1993; 103(2): 472-4.-DOI: https://doi.org/10.1378/chest.103.2.472.
Maiwand M.O. The role of cryosurgery in palliation of tracheo-bronchial carcinoma. Eur J Cardiothorac Surg. 1999; 15(6): 764-8.-DOI: https://doi.org/10.1016/S1010-7940(99)00121-9.
Hetzel M., Hetzel J., Schumann C., et al. Cryorecanalization: a new approach for the immediate management of acute airway obstruction. The J Thorac Cardiovasc Surg. 2004; 127(5): 1427-31.-DOI: https://doi.org/10.1016/j.jtcvs.2003.12.032.
Schumann C., Hetzel M., Babiak A.J., et al. Endobronchial tumor debulking with a flexible cryoprobe for immediate treatment of malignant stenosis. J Thorac Cardiovasc Surg. 2010; 139(4): 997-1000.-DOI: https://doi.org/10.1016/j.jtcvs.2009.06.023.
Inaty H., Folch E., Berger R., et al. Unimodality and multimodality cryodebridement for airway obstruction. A single-center experience with safety and efficacy. Ann Am Thorac Soc. 2016; 13(6): 856-61.-DOI: https://doi.org/10.1513/AnnalsATS.201508-486OC.
Jeong J.H., Kim J., Choi C.M., Ji W. Clinical outcomes of bronchoscopic cryotherapy for central airway obstruction in adults: An 11-years’ experience of a single center. J Korean Med Sci. 2023; 38(32).-DOI: https://doi.org/10.3346/jkms.2023.38.e244.
Vergnon J.M., Schmitt T., Alamartine E., et al. Initial combined cryotherapy and irradiation for unresectable non-small cell lung cancer. Chest. 1992; 102(5): 1436-40.-DOI: https://doi.org/10.1378/chest.102.5.1436.
Chung F.T., Chou C.L., Lo Y.L., et al. Factors affecting survival in patients with endobronchial malignant mass after flexible Bronchoscopic cryotherapy: a cohort study. BMC Pulm Med. 2019; 19(1): 101.-DOI: https://doi.org/10.1186/s12890-019-0854-2.
Simhan V., Lokeshwaran S., Gupta N., et al. Cryodebulking to relieve critical airway narrowing due to a central airway tumor at the carina: A case report and literature review. Cureus. 2024; 16(2): e53762.-DOI: https://doi.org/10.7759/cureus.53762.-URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC10921973/.
Sabel M.S. Cryo-immunology: A review of the literature and proposed mechanisms for stimulatory versus suppressive immune responses. Cryobiology. 2009; 58(1): 1-11.-DOI: https://doi.org/10.1016/j.cryobiol.2008.10.126.
Lin M., Liang S.Z., Wang X.H., et al. Clinical efficacy of percutaneous cryoablation combined with allogenic NK cell immunotherapy for advanced non-small cell lung cancer. Immunol Res. 2017; 65(4): 880-7.-DOI: https://doi.org/10.1007/s12026-017-8927-x.
Velez A., DeMaio A., Sterman D. Cryoablation and immunity in non-small cell lung cancer: a new era of cryo-immunotherapy. Front Immunol. 2023; 14: e1203539.-DOI: https://doi.org/10.3389/fimmu.2023.1203539.
Feng J., Guiyu D., Xiongwen W. The clinical efficacy of argon-helium knife cryoablation combined with nivolumab in the treatment of advanced non-small cell lung cancer. Cryobiology. 2021; 102: 92-6.-DOI: https://doi.org/10.1016/j.cryobiol.2021.07.007.
Abdo J., Cornell D.L., Mittal S.K., Agrawal DK. Immunotherapy plus cryotherapy: Potential augmented abscopal effect for advanced cancers. Front Oncol. 2018; 8.-DOI: https://doi.org/10.3389/fonc.2018.00085.
Gu X., Jiang Z., Fang W. Cryoablation combined with molecular target therapy improves the curative effect in patients with advanced non-small cell lung cancer. J Int Med Res. 2011; 39(5): 1736-43.-DOI: https://doi.org/10.1177/147323001103900516.
Eiken P.W., Welch B.T. Cryoablation of lung metastases: review of recent literature and ablation technique. Semin Intervent Radiol. 2019; 36(04): 319-25.-DOI: https://doi.org/10.1055/s-0039-1697002.
Kaseda K., Asakura K., Nishida R., et al. Feasibility and safety of percutaneous cryoablation under local anesthesia for the treatment of malignant lung tumors: a retrospective cohort study. J Thorac Dis. 2022; 14(11): 4297-308.-DOI: https://doi.org/10.21037/jtd-22-830.
Bourgouin P.P., Wrobel M.M., Mercaldo N.D., et al. Comparison of percutaneous image-guided microwave ablation and cryoablation for sarcoma lung metastases: A 10-year experience. Am J Roentgenol. 2022; 218(3): 494-504.-DOI: https://doi.org/10.2214/AJR.21.26551.
Leppelmann K.S., Levesque V.M., Bunck A.C., et al. Outcomes following percutaneous microwave and cryoablation of lung metastases from adenoid cystic carcinoma of the head and neck: A bi-institutional retrospective cohort study. Ann Surg Oncol. 2021; 28(11): 5829-39.-DOI: https://doi.org/10.1245/s10434-021-09714-4.
Perikleous P., Mayer N., Finch J., et al. Treatment of pulmonary carcinoid tumors with bronchoscopic cryotherapy. J Bronchology Interv Pulmonol. 2022; 29(1): 71-82.-DOI: https://doi.org/10.1097/LBR.0000000000000791.
Yılmaz A., Aktaş Z., Alici İ.O., et al. Cryorecanalization: keys to success. Surg Endosc. 2012; 26(10): 2969-74.-DOI: https://doi.org/10.1007/s00464-012-2260-1.
Это произведение доступно по лицензии Creative Commons «Attribution-NonCommercial-NoDerivatives» («Атрибуция — Некоммерческое использование — Без производных произведений») 4.0 Всемирная.
© АННМО «Вопросы онкологии», Copyright (c) 2025