title: A phase 1/pilot study of radiofrequency ablation for the treatment of recurrent pediatric solid tumors.
abstract: BACKGROUND
  This prospective study was designed to be the first to evaluate the toxicity of radiofrequency ablation (RFA) in patients with recurrent pediatric solid tumors.
  
  
  METHODS
  From 2003 through 2008, a phase 1/pilot study of RFA for recurrent pediatric solid tumors was conducted. A multidisciplinary cancer management team selected appropriate candidates for the study. Imaging-guided RFA was performed percutaneously. Repeat RFA was performed for recurrences when appropriate. Toxicity and imaging response was assessed at 1 month and 3 months prospectively. Accrual stopped in 2006, and data collection stopped in 2008.
  
  
  RESULTS
  Sixteen patients (ages 4 years-33 years; median age, 15 years) and 56 tumor sites were treated in 37 RFA sessions including 38 pulmonary, 11 musculoskeletal, and 7 hepatic lesions (82 lesion-treatments). Postprocedural pain was moderate (median 5 on a scale from 1 to 10) and lasted a median of 9 days. Prolonged hospitalization (beyond 1 day) occurred 17 times (range, 2 days-25 days; median, 3 days). Hypoxia supported by supplemental oxygen occurred in 8 of 16 patients and resolved within 1 month after each RFA. No patient had tumor lysis syndrome but myoglobinuria/hemoglobinuria occurred in 6 of 16 patients, all without renal damage. Serious complications from pulmonary RFA included 2 diaphragmatic hernias. Of 82 lesions imaged, 24 (29%) remained ablated at the end of the study.
  
  
  CONCLUSIONS
  The toxicity from RFA of recurrent pediatric solid tumors was real but limited, and RFA may offer a local tumor control alternative in carefully selected cases.
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, and Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA. fred.hoffer@seattlechildrens.org
authors.forename: Fredric A
authors.initials: FA
authors.lastname: Hoffer
authors.forename: Najat C
authors.initials: NC
authors.lastname: Daw
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Xiong
authors.forename: Doralina
authors.initials: D
authors.lastname: Anghelescu
authors.forename: Matthew
authors.initials: M
authors.lastname: Krasin
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Yan
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Davidoff
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Furman
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Spunt
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005334:Fever / Q000209:etiology; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008099:Liver; D009369:Neoplasms / Q000628:therapy*; D010865:Pilot Projects; D012008:Recurrence; D055815:Young Adult