title: Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report.
abstract: OBJECTIVE
  To assess technical feasibility, efficacy, and complications of percutaneous computed tomography (CT)-guided transthoracic radiofrequency (RF) ablation for treating inoperable non-small cell lung cancer (NSCLC) and lung metastases.
  
  
  METHODS
  Twenty-six patients with 27 NSCLCs and four patients with five lung metastases underwent RF ablation with cooled-tip electrodes with CT guidance. Patients were not candidates for surgery because of either advanced-stage disease (n = 20) and/or comorbid processes (n = 4) or refusal to undergo surgery (n = 6). The procedure was performed with the intent to cure in 10 (33%) patients with stage I tumors and as palliative therapy in 20 (67%) patients. Contrast material-enhanced CT was performed immediately, 1 month, and then every 3 months after RF ablation to evaluate the response to therapy. Time to death for each patient was calculated with Kaplan-Meier analysis, and the effect of tumor size and the extent of coagulation necrosis on time to death were determined.
  
  
  RESULTS
  Complete necrosis was attained in 12 (38%) of 32 lesions; partial (>50%) necrosis, in the remaining 20 (62%) lesions. Tumor size was a major discriminator in achieving complete necrosis. Complete necrosis was attained in all six (100%) tumors smaller than 3 cm but only in six (23%) of 26 larger tumors (P <.05). Mean survival of patients with complete necrosis (19.7 months) was significantly better than that of patients with partial necrosis (8.7 months) (P <.01). There were three (in 30 patients, 10%) major complications, which included acute respiratory distress syndrome, and two pneumothoraces that required thoracostomy.
  
  
  CONCLUSIONS
  RF ablation appears to be a safe and promising procedure for the treatment of inoperable NSCLC and metastases.
authors.affiliation: Departments of Radiology and Medicine, Chonbuk National University Hospital, South Korea. leejm@radcom.snu.ac.kr
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Gong Yong
authors.initials: GY
authors.lastname: Jin
authors.forename: S Nahum
authors.initials: SN
authors.lastname: Goldberg
authors.forename: Yong Cheol
authors.initials: YC
authors.lastname: Lee
authors.forename: Gyung Ho
authors.initials: GH
authors.lastname: Chung
authors.forename: Young Min
authors.initials: YM
authors.lastname: Han
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Lee
authors.forename: Chong Soo
authors.initials: CS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate