Endoscopic cryotherapy of lung and bronchial tumors: a systematic review.

Lee SH, Choi WJ, Sung SW, Kim YK, Kim CH, Zo JI, Park KJ.

Source

National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.

Abstract

BACKGROUND/AIMS:

We made a systematic review and evaluation of endoscopic cryotherapy of endobronchial tumors, investigating safety and efficacy.

METHODS:

Qualified studies regarding endoscopic cryotherapy of lung tumors were systemically evaluated using available databases according to predefined criteria.

RESULTS:

In total, 16 publications were included in the final assessment. A narrative synthesis was performed because a formal meta-analysis was not viable due to the lack of controlled studies and study heterogeneity. Overall success rates for significant recanalization of the obstruction were approximately 80%, although they varied, depending on disease status in the patient population. Complications from the procedure developed in 0-11.1% of cases, most of which were minor and controlled by conservative management. Although limited data were available on comprehensive functional assessment, some studies showed that respiratory symptoms, pulmonary function tests, and performance status were significantly improved.

CONCLUSIONS:

Endoscopic cryotherapy was found to be a safe and useful procedure in the management of endobronchial tumors although its efficacy and appropriate indications have yet to be determined in well-designed controlled studies.

Comment in

Korean J Intern Med. 2011 Jun;26(2):132-4.

PMID:: 21716589; [PubMed - indexed for MEDLINE]
PMCID:: PMC3110845

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Endoscopic cryotherapy was found to be a safe and useful procedure in the management of endobronchial tumors

d.d. 4 december 2003: Bron: Endocare
Nieuwe studies met cryosurgery (bevriezen via holle naald door huid heen) bij longtumoren lijken beloftevol en succesvol, aldus nieuwe klinische data gepresenteerd op de RSNA ( the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America). In verschillende studies zijn 187 patiënten met 234 longtumoren met deze nieuwe techniek behandeld en volgens de onderzoekers verdwenen de tumoren zonder echt zichtbare vervelende bijwerkingen bij het overgrote deel van de behandelde patiënten. Voordeel van deze techniek is ook dat er geen narcose meer aan te pas komt en slechts plaatselijk verdoofd wordt. Ook is bij longtumoren bevriezen te prefereren boven RFA - Radio Frequency Ablation - omdat er veel minder vochtontwikkeling bij komt waardoor de benauwdheid voor patiënten veel minder is. We hebben gezocht op internet naar abstracten van deze studies maar nog niet kunnen vinden. Wel veel studies van cryosurgery bij prostaatkanker en levertumoren en op de website van Endocare staat een uitgebreide beschrijving wat cryosurgery precies is en welke technieken ervoor worden gebruikt.

-- PRESS RELEASE: New Study on Percutaneous Thoracic Cryotherapy Promises Breakthrough --

IRVINE, Calif., Dec. 2 /PRNewswire-FirstCall/ -- Endocare Inc. (OTC: ENDO), an innovative medical device company focused on the development of minimally invasive technologies for tissue and tumor ablation, today announced that new clinical data presented at the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA) in Chicago shows that CT-guided, percutaneous lung cryotherapy (PLC) can be very effective in treating lung cancer tumors and results in minimal patient discomfort and minimal damage to adjacent tissues.

The study, presented today by Dr. Peter Littrup, Professor of Radiology at Wayne State School of Medicine, is a summary of the results of PLC performed on 187 patients with 234 total lesions. 217 PLC sessions were administered over a 13-month period. Treatment efficacy among patients in the study was high and at six months follow-up, the vast majority of treated areas were stable, smaller than the original tumor site or were destroyed completely. PLC involves the use of a slender cryoprobes inserted through the skin directly into the tumor. Extreme cold is then directed to the tumor, freezing the cancer cells. Most PLC patients receive only local anesthesia with minimal or no sedation, as compared to open surgery, which involves general anesthesia and a longer hospital stay. "This study is valuable in demonstrating the ability to treat lung tumors of various sizes and locations with cryotherapy," said Dr. Littrup. "An advantage of cryotherapy over radio frequency was noted in the relatively low rate of pneumothoraces [air pockets] that developed as a result of cryo, and the relative ease of managing them." Dr. Littrup continued, "In addition, patients with advanced disease felt significantly better within one week of cryotherapy." Endocare estimates that the total market opportunity to treat unresectable lung lesions exceeds $400 million annually.

About Endocare
Endocare Inc. -- www.endocare.com -- is an innovative medical device company focused on the development of minimally invasive technologies for tissue and tumor ablation. Endocare has initially concentrated on developing devices for the treatment of prostate cancer and believes that its proprietary technologies have broad applications across a number of markets, including the ablation of tumors in the kidney, lung, liver and bone.

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