Novel Image-Guided Flexible-Probe Transbronchial Microwave Ablation for Stage 1 Lung Cancer

Area of Science:

• Pulmonology
• Interventional Radiology
• Oncology

Background:

• Percutaneous thermal ablation for early-stage lung cancer carries risks of pleura-related complications like pneumothorax.
• Image-guided techniques are crucial for managing medically inoperable patients.

Purpose of the Study:

• To assess the feasibility of image-guided transbronchial microwave ablation (tMWA) for peripheral stage 1 lung cancer.
• To evaluate the safety and efficacy of this novel minimally invasive approach.

Main Methods:

• A prospective, single-arm, multicenter study enrolled patients with peripheral stage 1 lung tumors unsuitable for surgery.
• Ablation was performed using navigational bronchoscopy and a flexible microwave ablation probe, guided by cone-beam CT and augmented fluoroscopy.
• Follow-up included CT imaging, adverse event monitoring, and pulmonary function/quality of life assessments.

Main Results:

• Eleven tumors in 10 patients were successfully treated with technical success and efficacy.
• No tumor recurrence was observed at 12-month follow-up, and no major pleura-related complications occurred.
• Minor adverse events were noted, and two serious adverse events, including one death, led to enrollment halt, prompting further safety evaluation.

Conclusions:

• Image-guided transbronchial microwave ablation is a technically feasible option for peripheral early-stage lung cancer.
• Further research in larger patient cohorts is essential to fully establish the safety and efficacy profile of tMWA.