title: Bronchoscopy-Guided Cooled Radiofrequency Ablation as a Novel Intervention Therapy for Peripheral Lung Cancer.
abstract: BACKGROUND
  Our previous animal and preliminary human studies indicated that bronchoscopy-guided cooled radiofrequency ablation (RFA) for the lung is a safe and feasible procedure without major complications.
  
  
  OBJECTIVE
  The present study was performed to evaluate the safety, effectiveness and feasibility of computed tomography (CT)-guided bronchoscopy cooled RFA in patients with medically inoperable non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Patients with pathologically diagnosed NSCLC, who had no lymph node involvement or distant metastases (T1-2aN0M0) but were not surgical candidates because of comorbidities (e.g., synchronous multiple nodules, advanced age, cardiovascular disease, poor pulmonary function, etc.) were enrolled in the present study. The diagnosis and location between the nearest bronchus and target tumor were made by CT-guided bronchoscopy before the treatment. A total of 28 bronchoscopy-guided cooled RFA procedures were performed in 20 patients. After treatment, serial CT imaging was performed as follow-up.
  
  
  RESULTS
  Eleven lesions showed significant reductions in tumor size and 8 lesions showed stability, resulting in a local control rate of 82.6%. The median progression-free survival was 35 months (95% confidence interval: 22-45 months), and the 5-year overall survival was 61.5% (95% confidence interval: 36-87%). Three patients developed an acute ablation-related reaction (fever, chest pain) and required hospitalization but improved with conservative treatment. There were no other adverse events in the present study.
  
  
  CONCLUSIONS
  CT-guided bronchoscopy cooled RFA is applicable for only highly selected subjects; however, our trial may be an alternative strategy, especially for disease local control in medically inoperable patients with stage I NSCLC.
authors.affiliation: Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Koizumi
authors.forename: Kenji
authors.initials: K
authors.lastname: Tsushima
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tanabe
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Agatsuma
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Michiko
authors.initials: M
authors.lastname: Ito
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kanda
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuo
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D025321:Surgery, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome