P3-054: Safety and efficacy of percutaneous cryosurgery under the ct guidance for the treatment of lung cancer

Abstract

Many patients with lung cancer cannot undergo chemotherapy or radiation therapy due to impaired pulmonary function or poor general performance status. Most of them show resistance to these treatments, resulting in continued tumor growth and spreading. In such patients, minimally invasive treatments directed to local tumors may relieve patients from cancer pain or other generalized symptoms. As cryosurgery has been proven to be effective and also safe for cancers in prostate, kidneys, liver and endobronchial obstructive tumors, we sought to evaluate our results and safety of cryosurgery for lung cancer. At our hospital, from October, 2004 to December, 2005, 28 patients were treated by cryosurgery. The average age of the patients was 59.8. Of the 28 patients, 18 had primary lung cancer, and 10 had metastatic lung cancers. The average tumor size was 49.9mm. Cryosurgery was performed using a cryoprobe under CT guidance using local anesthesia. Follow up chest CT scan was taken at post operative day on 1 week, 1mo, 3mo and 6 months, and surgical final outcome was evaluated according to RECIST (complete remission, partial remission, stable disease, and progression). There were no procedure related mortalities. Postoperative pleural effusion was noted in 1 case (3.5%) and there were 9 cases (32%) of pneumothorax of which 3 needed closed thoracostomies. Small amounts of blood tinged sputum was noted by 15 of the patients (53.6%). Of the 28 patients, 3 patients (10.7%) showed complete remission and six (21.4%) resulted in disease progression. 21 patients (75%) of the patients exhibited response to the cryosurgical procedure. Cryosurgery for lung cancer can be performed safely under local anesthesia, and patients can be discharged early without serious complications. The effectiveness in local tumor destruction makes cryosurgery a promising option for the treatment of local tumors in patients with impaired pulmonary function, poor general performances, or those who refuse to take surgery