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Radiofrequency Ablation Treatment Could Replace Surgery for Lung Cancer: Presented at SIR
By Crina Frincu-Mallos, PhD
WASHINGTON, DC -- March 20, 2008 -- Percutaneous pulmonary radiofrequency ablation, an interventional therapy that destroys lung tumours by applying heat, was found to improve survival time from primary or metastatic inoperable lung tumours, researchers reported here at the Society of Interventional Radiology (SIR) 33rd Annual Scientific Meeting.
In a study of 244 patients with lung cancer who received this therapy, 90% were still alive at 1-year follow-up, and 72% were still alive at 2-year follow-up, said lead investigator Thierry de Bačre, MD, Interventional Radiologist, Institut Gustave Roussy, Villejuif, Val de Marne, France.
The study population consisted of 47 patients with primary non-small-cell lung cancer and 197 patients with lung metastases. Dr. de Bačre and colleagues treated 397 tumours -- 81% metastases and 19% primary tumours -- ranging in diameter from 0.4 to 7.0 cm.
The 147 men and 97 women had a median age of 62 years.
The tumours were treated in 301 radiofrequency ablation sessions. Usually, 1 lung was treated at a time, but there were 13 cases where the therapy was applied to both lungs at the same time, noted Dr. de Bačre in a presentation on March 17.
Most of the radiofrequency ablation sessions took place while the patient was under general anesthesia (n = 296). A small number of patients received the treatment under conscious sedation (n = 3) or local anesthesia (n = 2).
The rates of tumour progression were 6.1% per tumour at 1 year and 11.2% at 2 years. The rate was strongly dependent on the tumour size. For tumours smaller than 2 cm, the rate of progression was 3.7% at 1 year and 8.2% at 2 years, whereas for tumours larger than 2 cm, the rates of progression were 12.4% and 19.4% at 1 and 2 years, respectively (P = .002), noted Dr. de Bačre.
In terms of survival, from the time of the radiofrequency ablation survival was 88.7% at 1 year and 70.3% at 2 years.
For patients without pulmonary evolution, either at the radiofrequency ablation site or distant sites, 57.5% had no viable lung tumours at 1 year, and only 38.8% at 2 years, said Dr. de Bačre.
The survival results are similar to surgical results from other studies, but this procedure is minimally invasive, has fewer side effects, has a high local success rate, and requires less recovery time than surgery, said the researchers.
Most importantly, percutaneous pulmonary radiofrequency ablation is proving to be a curative option for nonsurgical patients -- the main limitation being the size of the tumour, stressed Dr. de Bačre.
[Presentation title: Long-Term Follow-Up After Pulmonary Radiofrequency Ablation. Abstract 106]
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