Percutaneous radiofrequency thermal ablation of primary and metastatic lung tumors

Abstract

Primary lung cancer is the leading cause of death from cancer. For patients with inoperable lung cancer, percutaneous radiofrequency thermal ablation (RFA) under CT-guidance represents a minimally invasive treatment. It can also be applied in combination with radiation therapy and chemotherapy. In a period of 18 months, RFA under CT-guidance 27 ablations were applied on 22 patients, 14 patients with primary lung cancer and 8 patients with metastatic lung tumor. There were 15 men and 7 women ranging in age between 48 and 79 years. All patients were not surgical candidates either due to the advanced stage or due to comorbid diseases, while five denied surgery. The lesions' size was no bigger than 6 cm (range 1-6 cm) with an average of 3.8 cm. The diagnosis of all treated lesions was obtained with percutaneous biopsy under CT guidance. The procedure was performed under local anesthesia. There were no major complications observed, but a small pneumothorax and a minor hemoptysis in four cases, all conservatively treated. All patients were hospitalized for 24h. Follow-up was initially done in 1, 3, 6 and 12 months after RFA and it was accomplished by personal interview or by telephone call up to December 2005. Median progression free intervals were 26.4 months for primary lung cancer and 29.2 months for metastatic tumor. RFA is a minimally invasive technique that can be used as a palliative treatment in nonsurgical candidates with primary or metastatic lung tumor with a low morbidity and mortality.