Cryoablation outshines radiation therapy, surgery for treating certain lung cancers
New data support the use of percutaneous cryoablation for patients with certain types of lung cancer who are not surgical candidates.
Published in the Journal of Vascular and Interventional Radiology, the findings suggest that the procedure offers effective local control and a favorable safety profile for patients with medically inoperable stage 1A non-small cell lung cancer (NSCLC). It is especially beneficial in scenarios involving lesions smaller than 2 cm, the study’s results suggest.
“Low-dose computed tomography screening now detects more early stage, potentially curable lesions. Yet, many screen-detected patients have smoking-related comorbidities (e.g., chronic obstructive pulmonary disease and cardiovascular disease), leaving ≥20 % medically unfit for surgery,” Sameer Rehman, MD, MBA, with the cardiothoracic and interventional radiology wing of Desert Radiology/Radiology Partners, Las Vegas, Nevada, and colleagues noted. “According to the most recent National Comprehensive Cancer Network guidelines...thermal ablative techniques, such as cryoablation, are acknowledged as a therapeutic option for select patients with Stage I NSCLC who are medically inoperable, have oligometastatic disease, or present with unresectable local recurrence after prior treatment.”
For the work, researchers analyzed the cases of 176 patients who underwent percutaneous cryoablation for biopsy-proven Stage IA NSCLC at a single institution between 2020 and 2025. Only patients with lesions smaller than 3 cm who either refused surgery or were not surgical candidates were included. CT and PET imaging were used to monitor patient outcomes.
The procedure yielded one- and three-year local progression-free survival (LPFS) rates of 91.8% and 89.4%, with local progression rates of just 10.6%; larger tumors (Stage IA3 vs IA2) were more likely to progress locally. Overall survival rates at the one-year mark were 100%, dipping slightly to 94.7% after three years.
In terms of safety, pneumothorax requiring intervention occurred in 17.6% of patients. However, there were no reports of in-hospital deaths, air embolism or massive pulmonary hemorrhage. These outcomes were similar to those reported in other studies on the use of cryoablation for NSCLC.
These latest findings suggest that the procedure’s efficacy and safety profile are in line with both surgery and radiation therapy treatments and fills an unmet need for a group of high-risk patients; the team contends this makes it a promising treatment candidate for this population.
“Percutaneous cryoablation provides effective local control with a favorable safety profile in patients with medically inoperable Stage IA NSCLC particularly with tumor smaller than 2 cm,” the group noted. “These results support further exploration of cryoablation as a primary treatment modality for this patient population.”
The full study is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.