Radiofrequency ablation of lymphoma

Abstract

6710 Background: The role of radiofrequency ablation (RFA) for the treatment of lymphoma is undocumented. We present three patients in whom RFA was used, for three different indications, to treat residual lymphomatous lesions unresponsive to conventional treatment. Methods: Three patients with isolated lymphoma masses were treated with percutaneous image-guided RFA. The first patient had a residual hepatic mass after EPOCH and rituximab chemotherapy for polymorphic post-transplant lymphoproliferative disorder. The second patient had a progressively enlarging follicular lymphoma adjacent to the bladder wall following prior maximum radiation therapy and CHOP chemotherapy and was treated with RFA for pain palliation. In the third case, the patient had a rapidly enlarging B-cell lymphoma of the right neck causing impending airway compromise. The water-cooled Radionics generator ablation system was used with a cluster needle probe in all cases. Impedence, temperature, power, current, and time were monitored closely. Patients were followed both clinically and with CT, MRI, or PET to evaluate for treatment response and/or recurrence of their lesions. Results: Following RFA, the first patient had complete radiological resolution of the hepatic masses and remains disease free at four years post-treatment. The second patient achieved a partial response to the pelvic mass, requiring a second ablation treatment for recurrent urinary symptoms. He remained with improved symptoms at most recent follow-up. Although the third patient had short-term relief of his neck pain and respiratory compromise post-ablation, he expired five weeks later from his lymphoma. Conclusions: These cases of chemoresistance, pain palliation, and pending airway compromise illustrate settings in which RFA may be a preferable treatment to radiation or surgery, producing potentially less morbidity than standard treatments. Previous studies have shown that RFA produces a robust inflammatory response and could lead to a boost in the immune response against lymphoma, especially when performed with costimulatory agents like vaccines or other immunostimulation. This study exemplifies ways in which RFA may help manage patients with lymphoma and few alternative therapies. No significant financial relationships to disclose.