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Microwave ablation plus chemotherapy versus chemotherapy in advanced non-small cell lung cancer: a multicenter, randomized, controlled, phase III clinical trial.
- Source :
-
European Radiology . May2020, Vol. 30 Issue 5, p2692-2702. 11p. 3 Charts, 2 Graphs. - Publication Year :
- 2020
-
Abstract
- <bold>Objectives: </bold>This prospective trial was performed to verify whether microwave ablation (MWA) in combination with chemotherapy could provide superior survival benefit compared with chemotherapy alone.<bold>Materials and Methods: </bold>From March 1, 2015, to June 20, 2017, treatment-naïve patients with pathologically verified advanced or recurrent non-small cell lung cancer (NSCLC) were randomly assigned to MWA plus chemotherapy group or chemotherapy group. The primary endpoint was progression-free survival (PFS), while the secondary endpoints included overall survival (OS), time to local progression (TTLP), and objective response rate (ORR). The complications and adverse events were also reported.<bold>Results: </bold>A total of 293 patients were randomly assigned into the two groups. One hundred forty-eight patients with 117 stage IV tumors were included in the MWA plus chemotherapy group. One hundred forty-five patients with 113 stage IV tumors were included in the chemotherapy group. The median follow-up period was 13.1 months and 12.4 months, respectively. Median PFS was 10.3 months (95% CI 8.0-13.0) in the MWA plus chemotherapy group and 4.9 months (95% CI 4.2-5.7) in the chemotherapy group (HR = 0.44, 95% CI 0.28-0.53; p < 0.0001). Median OS was not reached in the MWA plus chemotherapy group and 12.6 months (95% CI 10.6-14.6) in the chemotherapy group (HR = 0.38, 95% CI 0.27-0.53; p < 0.0001) using Kaplan-Meier analyses with log-rank test. The median TTLP was 24.5 months, and the ORR was 32% in both groups. The adverse event rate was not significantly different in the two groups.<bold>Conclusions: </bold>In patients with advanced NSCLC, longer PFS and OS can be achieved with the treatment of combined MWA and chemotherapy than chemotherapy alone.<bold>Key Points: </bold>• Patients treated with MWA plus chemotherapy had superior PFS and OS over those treated with chemotherapy alone. • The ORR of patients treated with MWA plus chemotherapy was similar to that of those treated with chemotherapy alone. • Complications associated with MWA were common but tolerable and manageable. [ABSTRACT FROM AUTHOR]
- Subjects :
- *NON-small-cell lung carcinoma
*CANCER chemotherapy
*COMBINATION drug therapy
*CLINICAL trials
*TREATMENT of lung tumors
*LUNG cancer treatment
*THERAPEUTIC use of antineoplastic agents
*LUNG cancer
*RESEARCH
*CARBOPLATIN
*RESEARCH methodology
*MICROWAVES
*CANCER relapse
*LUNG tumors
*DEOXYCYTIDINE
*PROGNOSIS
*EVALUATION research
*MEDICAL cooperation
*ORGANOPLATINUM compounds
*TREATMENT effectiveness
*COMPARATIVE studies
*RANDOMIZED controlled trials
*KAPLAN-Meier estimator
*CISPLATIN
*PACLITAXEL
*COMBINED modality therapy
*LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 09387994
- Volume :
- 30
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- European Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 142738719
- Full Text :
- https://doi.org/10.1007/s00330-019-06613-x