Primary Lung Cancer

Abstract

Thermal ablation is a newer tool in the therapeutic armamentarium for local control, but one with an established and increasingly important role to play in the overall paradigm of non-small cell lung cancer (NSCLC) treatment. Since the first description of thermal ablation for lung tumors over two decades ago, techniques, which were at one time novel, have been continually refined and developed to improve its safety and efficacy. Currently, image-guided thermal ablation (IGTA) is inclusive of radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CA) and is a form of local therapy or local ablative therapy that can be considered as a potential alternative to other local therapies. Of the forms of local control available, thermal ablation is a cost-effective alternative and the only one consistently associated with lung preservation, especially prudent in patients with compromised lung function. Multiple large series of patients have been published with long-term data, demonstrating favorable rates of local control and overall survival, and several clinical trials have been performed demonstrating the efficacy of the procedure in a controlled setting. As our understanding of both clinical and technical aspects of the thermal ablation has improved, its role within the greater context of lung cancer therapy has emerged, not only as a stand-alone form of local therapy for early-stage NSCLC but as an aggressive complement in advanced stage disease. As the procedure becomes further validated and adopted and technology and techniques continue to advance, more patients with early- and late-stage NSCLC will benefit from this treatment alternative.