BORIS - aBlação pOR mIcro-ondaS [Microwave Ablation]
60 patients around the world
Available in Brazil
This study was designed to prospectively evaluate the safety and effectiveness of microwave
ablation therapy in the treatment of metastatic lung lesions secondary to sarcoma. This
technique has been proven to be successful in producing greater areas of ablation, increasing
the chances of success and reducing the possibility of local recurrence, especially when
compared to radiofrequency ablation. There will be 60 consecutive patients diagnosed and
treated at the oncology clinic at the São Paulo State Cancer Institute that are going to
participate in this study, after meeting the inclusion/ exclusion criteria. This number may
be increased up to approximately about 20 patients, according to the sample behavior in the
initial analysis and follow-up. All patients will be informed about the benefits, risks,
complications and limitations related to the procedure and written informed consent will be
applied. Patients will also be informed that microwave ablation is a new technology in
Brazil, despite the extensive international experience and the results already validated in
the medical literature.
Logistic regression will be used to evaluate the success of the microwave ablation according
to the characteristics of the lesion before the procedure. Logistic regressions for
correlated data will be used to (a) evaluate the success of ablation according to all
registered lesion characteristics, i.e., numeric characteristics (including tumor size and
location) and categorical characteristics (histopathology of the primary tumor); (b) verify
if combinations of two or more features of the lesions pose significant independent
predictors for the success of ablation; and (c) construct a model to estimate the probability
of success of the microwave ablation based on lesion characteristics before the procedure.
The survival of patients will be assessed according to (a) the end result of the procedure
(patients will be classified in two groups: an effective ablation group and a non-effective
ablation group) and (b) the histopathological nature of the primary tumor. The survival rates
will be calculated using the Kaplan-Meier test. The log-rank test (x² value of Cox-Mantel)
will be used to determine statistically significant differences between the patients'
survival rates. The value of P less than 0.05 will be considered to indicate a statistically
significant difference for all analyses. Statistical software (Bias for Windows, version 8.4,
Epsilon Verlag, Frankfurt, Germany) will be used.
Instituto do Cancer do Estado de São Paulo
1Research sites
60Patients around the world
Requirements for the patient
All Gender
Medical requirements
Patients over 18 years;
Patients with lung metastases arising from sarcoma;
Patients who are not eligible for surgery for medical reasons, including limited cardiopulmonary reserve. In this cases we will perform a pulmonary function test (PFT) to determine if the patient can withstand ablation;
Patients with recurrent metastases after pneumectomy or metastases after surgical resection. In this cases we will perform a PFT to determine if the patient can withstand ablation;
Patients with pulmonary lesions with dimensions up to 3,0 cm in the largest axial diameter;
Patients with four or fewer lesions. In cases of bilateral metastases, we will evaluate the treatment of only one lung at a time, with an interval of at least two weeks for the treatment of the contralateral lung, respecting the clinical evolution of the patient.
Patients with no extrapulmonary metastases or just indolent extrapulmonary disease;
Patients with prior histopathological confirmation of pulmonary lesions.
Patients with primary disease without clinical control;
Presence of uncontrolled extrapulmonary disease, including lymph node progression;
Presence of hilar lesions or near the main bronchi;
Presence of five or more lung lesions and/or lesions larger than 3,0 cm in greatest axial length;
Presence of tumors infiltrating the chest wall, mediastinal and/or pleural dissemination;
Patients with severe coagulopathy (international normalized ratio (INR) > 1,5 or lower platelet count to 50000/mm³);
Patients with chronic obstructive pulmonary disease (COPD) stage III/ IV;
Patients with septicemia;
Patients refusing ablation treatment or participation in the study.
Sites
Instituto do Cancer do Estado de Sao Paulo
Recruiting
Av. Dr. Arnaldo, 251 - Cerqueira César, São Paulo - SP, 01246-000