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Cryoablation: physical and molecular basis with putative immunological consequences.

John G Baust1, Kristi K Snyder2, Kimberly L Santucci2

  • 1State University of New York, Binghamton, NY, USA.

International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
|December 5, 2019
PubMed
Summary

Cryoablation (CA) is a unique energy deprivation therapy impacting all cellular processes and inducing multiple cell death forms. This review explores CA

Keywords:
Cryoablationadjuvantscancercryo-immunologycryotherapyfreezingthermal therapy

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Area of Science:

  • Oncology
  • Cell Biology
  • Immunology

Background:

  • Cryoablation (CA) is a singular energy deprivation therapy affecting all cellular processes.
  • CA is independent of cell cycle stage and cellular stemness.
  • CA is typically a non-repetitive treatment, avoiding adaptive mutagenesis.

Purpose of the Study:

  • To identify the cascade of damaging effects of the freeze-thaw process in CA.
  • To elucidate the physical and molecular relationships underlying CA's effects.
  • To explore the immunological involvement (abscopic effect) and freeze-sensitizing adjuvants in CA.

Main Methods:

  • Review of existing literature on cryoablation mechanisms.
  • Analysis of cellular processes impacted by freeze-thaw cycles.
  • Investigation of immune responses and adjuvant strategies in CA.

Main Results:

  • CA induces cell death through ice-related physical damage, cellular stress responses, vascular stasis, and immune activation.
  • A thermal gradient necessitates freeze margin extension, a limitation mitigated by dual freeze-thaw cycles and adjuvants.
  • The abscopic effect suggests potential immunological involvement in CA's efficacy.

Conclusions:

  • Cryoablation offers a unique therapeutic approach by inducing comprehensive cellular damage and diverse cell death pathways.
  • Understanding the freeze-thaw cascade and immunological effects is crucial for optimizing CA.
  • Freeze-sensitizing adjuvants are key to overcoming limitations and enhancing tumor margin ablation.