Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report.
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.
Lee
Jeong Min
JM
Departments of Radiology and Medicine, Chonbuk National University Hospital, South Korea. leejm@radcom.snu.ac.kr
Jin
Gong Yong
GY
Goldberg
S Nahum
SN
Lee
Yong Cheol
YC
Chung
Gyung Ho
GH
Han
Young Min
YM
Lee
Sang Yong
SY
Kim
Chong Soo
CS
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