Percutaneous CT-guided radiofrequency ablation for clinical stage i non-small cell lung cancer

Objective. Percutaneous radiofrequency ablation with CT guidance is an innovative treatment for lung malignancy that was first introduced worldwide in 2000. We herein evaluated the effectiveness of this treatment in patients with clinical stage I lung cancer and summarize the principles, characteristics, indications and practical issues associated with radiofrequency ablation for lung malignancy.

Methods. We analyzed 50 nonsurgical patients (29 males and 21 females; mean age, 74.7 years) with clinical stage I (TA, n = 38; TB, n = 12) histologically proven non-small cell lung cancer who underwent percutaneous radiofrequency ablation with CT guidance. A total of 52 tumors were treated with 52 ablation sessions.

Results. The median follow-up period was 37 months. Local progression was observed in 16 (3l%) of the 52 tumors. The overall, cancer-specific and disease-free survival rates were 940o, lOO0o and 820o at one year, 860o, 930o and 640o at two years and 740o, 8O0o and S30o at three years, respectively. Therefore, radiofrequency ablation of clinical stage T non-small cell lung cancer provides promising patient survival outcomes, although local efficacy must be improved. Radiofrequency ablation for lung cancer is usually performed under local anesthesia and requires only a short hospital stay. Complications related to the procedure are generally not serious, indicating that this treatment is less invasive than surgery. However, based on our experience, lung tumors measuring more than 2 cm in diameter are not well controlled using radiofrequency ablation alone.

Conclusions. Since there are currently no randomized controlled clinical studies comparing radiofrequency ablation and surgery or stereotactic irradiation therapy for lung cancer, the data of retrospective cohort studies are primarily referenced in published papers. This is one reason why this treatment is not well accepted in the field of lung cancer therapy. However, radiofrequency ablation has the potential to be used as an alternative therapy for lung cancer in cases in which surgery or stereotactic irradiation therapy are contraindicated.