Radiofrequency Ablation for Inoperable Lung Cancer

Abstract

Lung cancer is among the most common malignancies in the world. Optimal treatments for unresectable primary lung cancer, local recurrence of lung cancer within a previous radiation field, pulmonary metastases, and small lung cancers (1 cm) have not been found. Radiofrequency ablation (RFA) has been increasingly performed as a local treatment for lung malignancies. Herein, we present a case of inoperable lung cancer that was successfully treated with a combination of RFA and radiotherapy. A 69-year-old man presented with exertion dyspnea of 3 weeks' duration. He had a remote history of larynx and lung cancer. The patient had remained in remission for 14 years until the current presentation. On physical examination, the patient was not in acute distress, and chest sounds were normal except for minimal prolongation of expiration. On a thorax computed tomography (CT) scan, a 2.3×1.7-cm, ill-defined, cystic lesion in the left upper lobe adjacent to major fissure was detected. CT-guided transthoracic fine needle aspiration biopsy revealed adenocarcinoma but the procedure was complicated by pneumothorax and hypercapnic respiratory failure. On account of the emerging medical inoperability, radiation therapy at 45 Gy in 3 fractions and RFA were performed successfully. After the ninth month of treatment, no fluorodeoxyglucose uptake was detected in the RFA application site in the control positron emission tomography-CT images (complete remission). RFA is a newer technique for lung cancer. Although the results of most studies were short and mid term, for patients with poor lung functions, RFA is an encouraging treatment modality, especially when combined with radiotherapy or chemotherapy in the presence of appropriate patient selection, adequate equipment, and experienced staff.