RFA Benefits Some Lung Cancer Patients

Preliminary results of a study suggest that radiofrequency ablation (RFA) guided by computed tomography (CT) may be an effective way of treating patients with non-small-cell lung cancer (NSCLC) whose tumors are unresectable. The study was reported in a scientific paper presented by Patrick E. Sewell, Jr., M.D., of the University of Mississippi Medical Center (Jackson, USA), at the annual meeting of the Radiological Society of North America (RSNA) in Chicago (IL, USA).

The study involved 29 patients with nonresectable NSCLC, most with squamous carcinoma or adenocarcinoma. More than half (56%) had stage IA or IB disease and another 20% had stage IIIB cancer. General anesthesia was given to 86% of patients, but 14% had the procedure while sedated but conscious. Doctors placed a LeVeen needle electrode in the tumor under CT guidance. Radiofrequency energy was then applied to an end-point of full system impedance, based on an algorithm that classified the tumors as parenchymal (59%), pleural-based (26%), or hilar/mediastinal (15%). After treatment, patients had regular follow-up CT chest studies.

Except for two lesions that had to be retreated, all thermal lesions progressively decreased in size, showing that only nonviable tissue remained. At three months, 23 of the 29 patients were alive with no evidence of recurrence. Nine deaths occurred after the procedure but none was caused by progression of the cancer in the lungs. After an average follow-up of 13 months, 20 of the 29 patients were alive, 19 of them without any evidence of viable cancer at the treatment site. The only major complication was parenchymal bleeding in one patient with marked coronary and cerebral atherosclerotic disease. Nearly one-third of the patients developed pneumothorax but it was promptly evacuated and only 15% required a chest tube. Pleural effusion complicated 15% of procedures and was linked to lesion size and treatment time.

Dr. Sewell concluded that RFA is a safe procedure with minor morbidity and mortality and provides reliable and reproducible necrosis of NSCLC. "For stage IA and IB tumors, preliminary results suggest that it may be an excellent substitute for patients unable to undergo traditional surgical resection.”




Related Links:
Univ. of Mississippi