The value of Cone-Beam CT-guided radiofrequency ablation in the treatment of pulmonary malignancies (≤3 cm).

Zi-Jun Xiang,Yun Wang,Ning Cui,En-Fu Du,Lin Xu,Huili Li,Bin Jiang,Yi Wang

doi:10.1042/bsr20181230

Abstract

The aim of this study is to explore the safety and efficacy of Cone-Beam computed tomography (CBCT) guided radiofrequency ablation (RFA) in the treatment of pulmonary malignancies. Thirty-one patients with pulmonary malignant tumors (≤3 cm in diameter) were enrolled to this study. Total 43 CBCT guided RFA treatments were performed, including 7 patients undergoing multiple treatments. The target tumor puncture success rate, tumor remission rate, postoperative cumulative survival rate, tumor-free survival rate and complication rate were analyzed. All 43 CBCT guided RFA procedures successfully punctured the target tumors. Complications included five cases of pneumothorax and three cases of hemoptysis. For the 31 patients who underwent CBCT guided RFA, the 1- and 2-year cumulative survival rates were 80.6 and 54.8%, respectively. The 1- and 2-year disease-free survival rates were 54.8 and 32.3%, respectively. The 1-, 3- and 6-month remission rates were 78.4, 68.7 and 63.3%, respectively. The average cumulative radiation dose and average effective radiation dose were 194.62 ± 105.51 mGy and 5.41 ± 3.45 mSv, respectively. CBCT help to shorten the operation time, reduce the unnecessary interventions and also reduce the incidence of complications. CBCT guided RFA is one safe and efficacious treatment for pulmonary malignancies.

Highlights

Cancer is the leading cause of death worldwide, accounting for 8.8 million deaths in 2015
Cazzato et al reported that compared with Computed tomography (CT) guidance, Cone-Beam computed tomography (CBCT) allowed faster lung Radiofrequency ablation (RFA) irrespective of the size of the lung lesion
CBCT guided RFA resulted in a lower rate of pneumothoraxes than with CT-guided RFA (37.5% for CBCT vs 42.8% for CT)

Summary

Introduction

Cancer is the leading cause of death worldwide, accounting for 8.8 million deaths in 2015. Lung cancer is the leading cause of cancer mortality for men worldwide and for women in developed countries. The efficacy and safety of RFA for lung cancers are evaluated and studies suggested that RFA was one safe and efficient treatment for the patients with lung cancers [7]. It is especially available for patients, who do not have the opportunity to undergo surgery, high-risk patients unsuitable for surgery and for patients with pulmonary metastasis and refused to receive surgery [8]

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