Advances in Local Ablation Strategies for Treating Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.55927/eajmr.v4i10.407Keywords:
Lung Cancer, Non-Small Cell Lung Cancer, Cryoablation, Microwave Ablation, Survival RatesAbstract
Lung cancer represents foremost cause of cancer-related mortality globally. Non-small cell lung cancer (NSCLC) is the most prevalent, over 85% of all lung cancer diagnoses. The literature search was performed through databases including PubMed, Scopus, Web of Science, and ScienceDirect up to September 2025. In adverse events after both procedures including pneumothorax, bronchopulmonary hemorrhage, hemoptysis, and pleural effusion events between CA and MWA group were not significant reported (p = 0.97).. CA and MWA showed comparable effectiveness due to its minimally invasiveness, providing similar response for early and advanced-stage in NSCLC with small tumor size (<3 cm). Both procedures also offered minimizing adverse events. However, CA was a longer hospitalization than MWA.
References
Reyes A, Pharaon R, Mohanty A, Massarelli E. Arising Novel Agents in Lung Cancer: Are Bispecifics and ADCs the New Paradigm? Vol. 15, Cancers. Multidisciplinary Digital Publishing Institute (MDPI); 2023.
Wei Z, Yang X, Wu J, Zhang P, Huang G, Ni Y, et al. SPACES: Our team’s experience in lung tumor microwave ablation. Vol. 19, Journal of Cancer Research and Therapeutics. Wolters Kluwer Medknow Publications; 2023. p. 1–13.
Rueth NM, Parsons HM, Habermann EB, Groth SS, Virnig BA, Tuttle TM, et al. Surgical treatment of lung cancer: Predicting postoperative morbidity in the elderly population. Journal of Thoracic and Cardiovascular Surgery. 2012 Jun;143(6):1314–23.
Li, Hong-Wei & Long, Yong-Jun & Yan, Gao-Wu & Bhetuwal, Anup & Zhuo, Li-Hua & Yao, Hong-Chao & Zhang, Jie & Zou, Xing-Xiong & Hu, Pei-Xi & Yang, Han-Feng & Du, Yong. (2022). Microwave ablation vs. cryoablation for treatment of primary and metastatic pulmonary malignant tumors. Molecular and Clinical Oncology. 16. 10.3892/mco.2022.2495.
Rodak O, Peris-Díaz MD, Olbromski M, Podhorska-Okołów M, Dzięgiel P. Current landscape of non-small cell lung cancer: Epidemiology, histological classification, targeted therapies, and immunotherapy. Cancers (Basel). 2021 Sep 1;13(18).
Noronha V, Budukh A, Chaturvedi P, Anne S, Punjabi A, Bhaskar M, et al. Uniqueness of lung cancer in Southeast Asia [Internet]. 2024. Available from: https://gco.iarc.fr/.
Kementerian Kesehatan Republik Indonesia; Komite Penanggulangan Kanker Nasional; Perhimpunan Dokter Paru Indonesia. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Kanker Paru [Internet]. Jakarta; 2023 Jun [cited 2025 Sep 20]. Available from: https://kemkes.go.id/id/pnpk-2023---tata-laksana-kanker-paru
Okada S, Shimomura M, Ishihara S, Ikebe S, Furuya T, Inoue M. Clinical significance of postoperative pulmonary complications in elderly patients with lung cancer. Interact Cardiovasc Thorac Surg. 2022 Aug 1;35(2).
Zhang W, Liu W, Wu ZL, Zhao ZY, Ma WM. Percutaneous ablation for adrenal metastasis from non-small-cell lung cancer: comparison between cryoablation and microwave ablation. Wideochir Inne Tech Maloinwazyjne. 2024 Mar;19(1):52-59. doi: 10.5114/wiitm.2024.134804. Epub 2024 Jan 30. PMID: 38974767; PMCID: PMC11223533.
Quirk MT, Lee S, Murali N, Genshaft S, Abtin F, Suh R. Alternatives to Surgery for Early-Stage Non–Small Cell Lung Cancer: Thermal Ablation. Vol. 41, Clinics in Chest Medicine. W.B. Saunders; 2020. p. 197–210.
Das SK, Huang YY, Li B, Yu XX, Xiao RH, Yang HF. Comparing cryoablation and microwave ablation for the treatment of patients with stage IIIB/IV non-small cell lung cancer. Oncol Lett. 2020;19(1):1031–41.
Wang Y, Guo R, Bie Z, Li B, Li X. Safety and efficacy of co-ablation vs. microwave ablation in the treatment of subpleural stage I non-small cell lung cancer: a comparative study. J Thorac Dis. 2025 Aug 31;17(8):5534–46.
Kristina Gregory, N., Lisa Hang, M., Aisner, D. L., Akerley, W., Bauman, J. R., Bruno, D. S., Chang, J. Y., Chirieac, L. R., DeCamp, M., Desai, A. P., Dilling, T. J., Dowell, J., Durm, G. A., Gettinger, S., Grotz, T. E., Gubens, M. A., Juloori, A., Lackner, R. P., Buffett Cancer Center Michael Lanuti, P., … Yau, E. (2024). NCCN Guidelines Version 3.2024 Non-Small Cell Lung Cancer Continue NCCN Guidelines Panel Disclosures. https://www.nccn.org/home/member-
Laeseke, P., Ng, C., Ferko, N., Naghi, A., Wright, G. W. J., Wang, D., Laidlaw, A., Kalsekar, I., Amos, T., Laxmanan, B., Ghosh, S. K., Zhou, M., Szapary, P., & Pritchett, M. (2025). Stereotactic body radiation therapy and thermal ablation for treatment of patients with pulmonary metastases: a systematic literature review and meta-analysis. In BMC Pulmonary Medicine (Vol. 25, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s12890-025-03561-9
Iezzi, R., Cioni, R., Basile, D. et al. Standardizing percutaneous Microwave Ablation in the treatment of Lung Tumors: a prospective multicenter trial (MALT study). Eur Radiol 31, 2173–2182 (2021). https://doi.org/10.1007/s00330-020-07299-2
Nan FY, Liu XF, An P, Bian LJ, Deng KL, Huo XS, Zou H, Wang HW, Li L. Comparison of the efficacy and adverse events between argon-helium cryoablation and microwave ablation for non-small cell lung cancer: a propensity score matching study. J Thorac Dis. 2025 Jul 31;17(7):4587-4599. doi: 10.21037/jtd-2024-2228. Epub 2025 Jul 22. PMID: 40809279; PMCID: PMC12340268.
V. Sankar, R. Kothai, N. Vanisri, Akilandeswari S., & G. Anandharaj. (2023). Lung cancer: a review. In International Journal of Health Sciences and Research (Vol. 13, Issue 10, pp. 307–315). IJHSR (www.ijhsr.org):contentReference[oaicite:7]{index=7}. https://doi.org/10.52403/ijhsr.20231042
Vogl, Thomas & Naguib, Nagy & Gruber-Rouh, Tatjana & Koitka, Karen & Lehnert, Thomas & Nour-Eldin, Nour-Eldin. (2011). Microwave Ablation Therapy: Clinical Utility in Treatment of Pulmonary Metastases. Radiology. 261. 643-51. 10.1148/radiol.11101643.
Lim E, Baldwin D, Beckles M, Duffy J, Entwisle J, Faivre-Finn C, Kerr K, Macfie A, McGuigan J, Padley S, Popat S, Screaton N, Snee M, Waller D, Warburton C, Win T; British Thoracic Society; Society for Cardiothoracic Surgery in Great Britain and Ireland. Guidelines on the radical management of patients with lung cancer. Thorax. 2010 Oct;65 Suppl 3:iii1-27. doi: 10.1136/thx.2010.145938. PMID: 20940263.
Society for Medical Oncology, E. (2019). Non-Small-Cell Lung Cancer ESMO Patient Guide Series based on the ESMO Clinical Practice Guidelines.
Wrobel, M.M., Cahalane, A.M., Pachamanova, D. et al. Comparison of expected imaging findings following percutaneous microwave and cryoablation of pulmonary tumors: ablation zones and thoracic lymph nodes. Eur Radiol 32, 8171–8181 (2022). https://doi.org/10.1007/s00330-022-08905-1
Rangamuwa, K., Leong, T., Weeden, C., Asselin-Labat, M. L., Bozinovski, S., Christie, M., John, T., Antippa, P., Irving, L., & Steinfort, D. (2021). Thermal ablation in non-small cell lung cancer: A review of treatment modalities and the evidence for combination with immune checkpoint inhibitors. In Translational Lung Cancer Research (Vol. 10, Issue 6, pp. 2842–2857). AME Publishing Company. https://doi.org/10.21037/tlcr-20-1075
Hinshaw JL, Littrup PJ, Durick N, Leung W, Lee Jr FT, Sampson Let al. Optimizing the protocol for pulmonary cryoablation: a comparison of a dual- and triple-freeze protocol. Cardiovasc Intervent Radiol 2010;33:1180—5
Fintelmann, F. J., Graur, A., Oueidat, K., Simon, J., Harvey Barnes, J. M., McDermott, S., Abtin, F. (2024). Ablation of Stage I–II Non–Small Cell Lung Cancer in Patients With Interstitial Lung Disease: A Multicenter Retrospective Study. American Journal of Roentgenology, 222(2). https://doi.org/10.2214/AJR.23.3030
Wei Z, Wang J, Ye X, et al. Computed tomography-guided percutaneous microwave ablation of early stage non-small cell lung cancer in a pneumonectomy patient. Thorac Cancer 2016; 7: 151-153.
Hess A, Palussière J, Goyers JF, et al. Pulmonary radiofrequency ablation in patients with a single lung: feasibility, efficacy, and tolerance. Radiology 2011; 258: 635-642.
Yim, S., Lin, W. C., Liu, J. Sen, & Yen, M. H. (2024). Survival after thermal ablation versus wedge resection for stage I non-small cell lung cancer < 1 cm and 1 to 2 cm: evidence from the US SEER database. Cancer Imaging, 24(1). https://doi.org/10.1186/s40644-024-00733-4
Cheung, T.T., Ma, K.W., and She, W.H. (2021). A review on radiofrequency, microwave and high-intensity focused ultrasound ablations for hepatocellular carcinoma with cirrhosis. Hepatobiliary Surg. Nutr. 10,193–209.
Nomori H, Yamazaki I, Shiraishi A, Adachi T, Kanno M. Cryoablation for T1N0M0 non-small cell lung cancer using liquid nitrogen. Eur J Radiol 2020;133:109334.
Yin, L., Li, X.Y., Zhu, L.L., Chen, G.L., Xiang, Z., Wang, Q.Q., Bi, J.W., and Wang, Q. (2022). Clinical application status and prospect of the combined anti-tumor strategy of ablation and immunotherapy. Front. Immu nol. 13, 965120.
Takahashi, H., and Berber, E. (2020). Role of thermal ablation in the management of colorectal liver metastasis. Hepatobiliary Surg. Nutr. 29, 49–58
Carberry, G.A., Nocerino, E., Mason, P.J., Schwahn, D.J., Hetzel, S., Turnquist, A.M., Lee, F.T., Jr., and Brace, C.L. (2017). Pulmonary Microwave Ablation Near the Heart: Antenna Positioning Can Mitigate Cardiac Complications in a Porcine Model. Radiology 282, 892–902.
Kakamad, Fahmi & Ali, Rebaz & Tahir, Soran & Salih, Ameer & Abdalla, Berun & Pshtiwan, Lana & Qaradakhy, Aras & Ahmed, Harem & Ahmed, Sasan & Mahmood, Yousif & Abdullah, Fakher & Hamasaeed, Mohammed & Salih, Abdulwahid. (2024). Microwave Ablation with or Without Chemotherapy in Management of Non-Small Cell Lung Cancer: A Systematic Review. Barw Medical Journal. 10.58742/bmj.v2i4.147.
Yang X, Ye X, Huang G, Han X, Wang J, Li W, Wei Z and Meng M: Repeated percutaneous microwave ablation for local recurrence of inoperable Stage I nonsmall cell lung cancer. J Cancer Res Ther. 13:683–688. 2017
Sun, Y., Cheng, Z., Dong, L., Zhang, G., Wang, Y., and Liang, P. (2012). Comparison of temperature curve and ablation zone between 915- and 2450-MHz cooled-shaft microwave antenna: results in ex vivo porcine livers. Eur. J. Radiol. 81, 553–557.’
Xie, X., Li, K., Chen, L., Li, H., Meng, C., & Zheng, L. (2025). Development of a predictive model for pneumothorax after microwave ablation based on radiomics and clinical baseline data. BMC Pulmonary Medicine, 25(1). https://doi.org/10.1186/s12890-025-03850-3
Liu H and Steinke K: High-powered percutaneous microwave ablation of stage I medically inoperable non-small cell lung cancer: A preliminary study. J Med Imaging Radiat Oncol. 57:466–474. 2013.
Hiyoshi Y, Miyamoto Y, Kiyozumi Y et al (2019) CT-guided percutaneous adiofrequency ablation for lung metastases from colorectal cancer. Int J Clin Oncol 24:288–295
Abrishami Kashani, Maya & Murphy, Mark & Sänger, Jonathan & Wrobel, Maria & Tahir, Ismail & Mrah, Sofiane & Ringer, Stefan & Bunck, Alexander & Silverman, Stuart & Shyn, Paul & Pachamanova, Dessislava & Fintelmann, Florian. (2023). Risk of persistent air leaks following percutaneous cryoablation and microwave ablation of peripheral lung tumors. European radiology. 33. 10.1007/s00330-023-09499-y.
Bourgouin, Patrick & Wrobel, Maria & Mercaldo, Nathaniel & Murphy, Mark & Leppelmann, Konstantin & Levesque, Vincent & Muniappan, Ashok & Silverman, Stuart & Shepard, JoAnne & Shyn, Paul & Fintelmann, Florian. (2021). Comparison of Percutaneous Image-Guided Microwave and Cryoablation for Sarcoma Lung Metastases: 10-Year Experience. AJR. American journal of roentgenology. 218. 10.2214/AJR.21.26551.
Tan, C. Q. Y., Ho, A., Robinson, H. A., Huang, L., Ravindran, P., Chan, D. L., Alzahrani, N., & Morris, D. L. (2023). A Systematic Review of Microwave Ablation for Colorectal Pulmonary Metastases. In Anticancer Research (Vol. 43, Issue 7, pp. 2899–2907). International Institute of Anticancer Research. https://doi.org/10.21873/anticanres.16461
Ald Alduais Y, Zhang H, Fan F, Chen J, Chen B. Non-small cell lung cancer (NSCLC): a review of risk factors, diagnosis, and treatment. Medicine. 2023;102(8). doi:10.1097/MD.0000000000032899
Cui X, Zhao J, Lu R, Sui Y, Shao C, Zhang Z, Chen J. Microwave ablation after VATS in patients with multiple pulmonary nodules. J Cancer Res Ther 2024;20:2029‑34.
Boeri, L. & Lucignani, G. & Ierardi, Anna & Piasentin, Andrea & Trombetta, Carlo & Liguori, Giovanni & Bertolotto, Michele & Rizzo, Massimiliano & Carrafiello, Gianpaolo & Montanari, Emanuele. (2022). Percutaneous microwave ablation is comparable to cryoablation for the treatment of T1a renal masses: Results from a cross-sectional study. European Urology. 81. S340. 10.1016/S0302-2838(22)00304-9.
Niu L, Zhou L, Xu K, Mu F. The role of cryosurgery in palliative care for cancer. Ann Palliat Med. 2013 Jan;2(1):26-34. doi: 10.3978/j.issn.2224-5820.2013.01.09. PMID: 25841740.
Callstrom MR, Woodrum DA, Nichols FC, Palussiere J, Buy X, Suh RD, et al. Multicenter study of metastatic lung tumors targeted by interventional cryoablation evaluation (SOLSTICE). J Thorac Oncol (2020) 15:1200–9. doi: 10.1016/j.jtho.2020.02.022
Lassandro, G., Picchi, S. G., Corvino, A., Gurgitano, M., Carrafiello, G., Lassandro, F. (2023). Ablation of pulmonary neoplasms: review of literature and future perspectives. Polish Journal of Radiology, 88, 216-224. https://doi.org/10.5114/pjr.2023.127062
Seror O., Ablative therapies: Advantages and disadvantages of radiofrequency, cryotherapy, microwave and electroporation methods, or how to choose the right method for an individual patient, Diagnostic and Interventional Imaging, Volume 96, Issue 6, 2015, Pages 617-624, ISSN 2211-5684, https://doi.org/10.1016/j.diii.2015.04.007.
Belfiore G, Ronza F, Belfiore MP, Serao N, di Ronza G, Grassi R and Rotondo A: Patients' survival in lung malignancies treated by microwave ablation: Our experience on 56 patients. Eur J Radiol. 82:177–181. 2013.
McDevitt JL, Mouli SK, Nemcek AA, Lewandowski RJ, Salem R, Sato KT. Percutaneous cryoablation for the treatment of primary and metastatic lung tumors: Identification of risk factors for recurrence and major complications. J Vasc Interv Radiol (2016) 27:1371–9. doi: 10.1016/j.jvir.2016.04.005
Liu, X., Zhan, Y., Wang, H., Tang, X., & Cheng, Y. (2025). Radiofrequency ablation versus microwave ablation for lung cancer/lung metastases: a meta‐analysis. ANZ Journal of Surgery, 95(1–2), 56–65. https://doi.org/10.1111/ans.19376
Xu, Z., Wang, X., Ke, H., & Lyu, G. (2023). Cryoablation is superior to radiofrequency ablation for the treatment of non-small cell lung cancer: A meta-analysis. In Cryobiology (Vol. 112). Academic Press Inc. https://doi.org/10.1016/j.cryobiol.2023.104560
Steinke K, Glenn D, King J et al (2004) Percutaneous imaging-guided radiofrequency ablation in patients with colorectal pulmonary metastases: 1-year follow-up. Ann Surg Oncol 11:207–212
King J, Glenn D, Clark W et al (2004) Percutaneous radiofrequency ablation of pulmonary metastases in patients with colorectal cancer. Br J Surg 91:217–223
Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 174:57–59
Hiyoshi Y, Miyamoto Y, Kiyozumi Y et al (2019) CT-guided percutaneous radiofrequency ablation for lung metastases from colorectal cancer. Int J Clin Oncol 24:288–295
Cheng M, Fay M, Steinke K (2016) Percutaneous CT-guided thermal ablation as salvage therapy for recurrent non-small cell lung cancer after external beam radiotherapy: A retrospective study. Int J Hyperthermia 32:316–323
Jiang, Tiger & McClure, Morgan & Chen, Tianming & Chen, Shilin. (2018). Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis. Annals of Thoracic Medicine. 13. 243. 10.4103/atm.ATM_392_17.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Rizky Dimasyah Putra Wahab, Setiadi Drajad Kurniawan, Jonathan Overian Buon, Nadhifa Tanesha Aufazhafarin

This work is licensed under a Creative Commons Attribution 4.0 International License.





























