Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis

Abstract Objective To compare local tumor progression (LTP) and overall survival (OS) after image-guided thermal ablation (IGTA; microwave/radiofrequency ablation) versus stereotactic body radiation therapy (SBRT) in patients with pulmonary metastases. Methods A systematic literature review was perf...

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Main Authors: Paul Laeseke, Calvin Ng, Nicole Ferko, Andrada Naghi, George W.J. Wright, Di Wang, Alyshia Laidlaw, Iftekhar Kalsekar, Tony Amos, Balaji Laxmanan, Sudip K. Ghosh, Meijia Zhou, Philippe Szapary, Michael Pritchett
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03561-9
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author Paul Laeseke
Calvin Ng
Nicole Ferko
Andrada Naghi
George W.J. Wright
Di Wang
Alyshia Laidlaw
Iftekhar Kalsekar
Tony Amos
Balaji Laxmanan
Sudip K. Ghosh
Meijia Zhou
Philippe Szapary
Michael Pritchett
author_facet Paul Laeseke
Calvin Ng
Nicole Ferko
Andrada Naghi
George W.J. Wright
Di Wang
Alyshia Laidlaw
Iftekhar Kalsekar
Tony Amos
Balaji Laxmanan
Sudip K. Ghosh
Meijia Zhou
Philippe Szapary
Michael Pritchett
author_sort Paul Laeseke
collection DOAJ
description Abstract Objective To compare local tumor progression (LTP) and overall survival (OS) after image-guided thermal ablation (IGTA; microwave/radiofrequency ablation) versus stereotactic body radiation therapy (SBRT) in patients with pulmonary metastases. Methods A systematic literature review was performed to capture studies that used IGTA or SBRT for patients with pulmonary metastases and studies that reported one, two, and threeyear LTP/OS were included. Patients with pulmonary metastases, and a subgroup with metastases from colorectal or renal cell carcinoma, or sarcoma (termed subgroup) which are considered more radioresistant, were analyzed. Single-arm pooled analyses, univariable, and multivariable random-effects meta-regressions were conducted to compare LTP and OS between IGTA and SBRT treated patients. Results Analyses included 3,264 IGTA and 5,486 SBRT patients. IGTA patients with pulmonary metastases had higher LTP than SBRT patients at one year, 13% and 9% respectively. At two years, the LTP for IGTA patients was 14% compared to 16% for SBRT patients. Three-year LTP remained lower for IGTA patients compared to SBRT patients (14% and 22% respectively). In the subgroup, SBRT patients had higher LTP than IGTA patients across all timepoints. OS was similar across analyses/subgroups in the single-arm pooled analyses. The multivariable analyses showed that SBRT was associated with significantly lower OS at one year; however nonsignificant differences were observed at years two and three. Conclusions In patients with pulmonary metastases, IGTA had lower LTP than SBRT at later timepoints. In patients with colorectal, renal cell carcinoma, or sarcoma pulmonary metastases, LTP was similar to overall LTP for IGTA, while it was higher for SBRT.
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spelling doaj-art-e20f3ce93dd643fc98a9479115fb7c092025-08-20T02:30:19ZengBMCBMC Pulmonary Medicine1471-24662025-04-0125111110.1186/s12890-025-03561-9Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysisPaul Laeseke0Calvin Ng1Nicole Ferko2Andrada Naghi3George W.J. Wright4Di Wang5Alyshia Laidlaw6Iftekhar Kalsekar7Tony Amos8Balaji Laxmanan9Sudip K. Ghosh10Meijia Zhou11Philippe Szapary12Michael Pritchett13Radiology, University of WisconsinDepartment of Surgery, The Chinese University of Hong Kong, Prince of Wales HospitalEVERSANAEVERSANAEVERSANAEVERSANAEVERSANALung Cancer Initiative, Johnson & JohnsonLung Cancer Initiative, Johnson & JohnsonLung Cancer Initiative, Johnson & JohnsonHealth Economics and Market Access, Johnson & JohnsonMedical Technology Epidemiology and Real World Data Science, Johnson & JohnsonLung Cancer Initiative, Johnson & JohnsonPulmonary and Critical Care Medicine, FirstHealth Moore Regional Hospital, and Pinehurst Medical ClinicAbstract Objective To compare local tumor progression (LTP) and overall survival (OS) after image-guided thermal ablation (IGTA; microwave/radiofrequency ablation) versus stereotactic body radiation therapy (SBRT) in patients with pulmonary metastases. Methods A systematic literature review was performed to capture studies that used IGTA or SBRT for patients with pulmonary metastases and studies that reported one, two, and threeyear LTP/OS were included. Patients with pulmonary metastases, and a subgroup with metastases from colorectal or renal cell carcinoma, or sarcoma (termed subgroup) which are considered more radioresistant, were analyzed. Single-arm pooled analyses, univariable, and multivariable random-effects meta-regressions were conducted to compare LTP and OS between IGTA and SBRT treated patients. Results Analyses included 3,264 IGTA and 5,486 SBRT patients. IGTA patients with pulmonary metastases had higher LTP than SBRT patients at one year, 13% and 9% respectively. At two years, the LTP for IGTA patients was 14% compared to 16% for SBRT patients. Three-year LTP remained lower for IGTA patients compared to SBRT patients (14% and 22% respectively). In the subgroup, SBRT patients had higher LTP than IGTA patients across all timepoints. OS was similar across analyses/subgroups in the single-arm pooled analyses. The multivariable analyses showed that SBRT was associated with significantly lower OS at one year; however nonsignificant differences were observed at years two and three. Conclusions In patients with pulmonary metastases, IGTA had lower LTP than SBRT at later timepoints. In patients with colorectal, renal cell carcinoma, or sarcoma pulmonary metastases, LTP was similar to overall LTP for IGTA, while it was higher for SBRT.https://doi.org/10.1186/s12890-025-03561-9Systematic literature reviewStereotactic body radiation therapyMicrowave ablationRadiofrequency ablationMeta regressionMeta-analysis
spellingShingle Paul Laeseke
Calvin Ng
Nicole Ferko
Andrada Naghi
George W.J. Wright
Di Wang
Alyshia Laidlaw
Iftekhar Kalsekar
Tony Amos
Balaji Laxmanan
Sudip K. Ghosh
Meijia Zhou
Philippe Szapary
Michael Pritchett
Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis
BMC Pulmonary Medicine
Systematic literature review
Stereotactic body radiation therapy
Microwave ablation
Radiofrequency ablation
Meta regression
Meta-analysis
title Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis
title_full Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis
title_fullStr Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis
title_full_unstemmed Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis
title_short Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis
title_sort stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases a systematic literature review and meta analysis
topic Systematic literature review
Stereotactic body radiation therapy
Microwave ablation
Radiofrequency ablation
Meta regression
Meta-analysis
url https://doi.org/10.1186/s12890-025-03561-9
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