Radiofrequency Ablation(RFA)  is a tool used primarily for liver cancer and liver metastases. Percutaneous radiofrequency coagulation is performed by using an electrode placed in the lesion, coupled with a radiofrequency generator that produces local tissue destruction by converting radiofrequency into heat. After the liver, most reports are of lung, breast and kidney cancers. There are is very little literature to guide its use for recurrent chest wall tumors. A large case series by Dupuy included 19 cancers in the chest wall skeleton. It concluded that this technique can safely palliate pain but did not provide information on overall survival and recurrence rates. RFA has been reported to cause nerve damage and nonehaling wounds. There is also the expense of this procedure and the radiation exposure to operators and patients. It would be prudent to obtain more experimental information before routinely using this procedure for recurrent chest wall tumors.

J. H. Lefevre, Y. Parc, M. Lewinet al, Radioequency ablation for recurrent pelvic cancer Colorectal Disease, Volume 10, Issue 8, pages 781–784, October 2008

Arianna Bertocchini, Radiofrequency Thermoablation in Chest Wall Mesenchymal Hamartoma of an Infant  Thorac Surg 2007;84:2091-2093

D. E. Dupuy, D. Liu, D. Hartfeil, L. Hanna, J. Blume, K. Ahrar, R. Lopez, H. Safran, T. DiPetrillo and W. Mayo-Smith, rcutaneous radiofrequency ablation of painful osseous metastases: A multicenter trial: American College of Radiology Imaging Network 6661  Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 25, No 18S (June 20 Supplement), 2007: 9101
 

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The usual use for SBRT is to attempt a cure or occasionally to control symptomatic lung metastases. It should be realized that this is not a treatment that is free from potential side effects. American Society for Therapeutic Radiation and Oncology (ASTRO, 2007) stated that SBRT is considered appropriate for the treatment of the following conditions:

Lung or liver metastases not amenable to surgery
Medically inoperable early stage lung cancer
Primary liver cancer not amenable to surgery
Recurrent lung cancer amenable to salvage therapy
Recurrent pelvic tumors
Retroperitoneal tumors
Spinal and para-spinous tumors
Other recurrent cancers or tumors.

https://www.isrsy.org/en/radiosurgery/guidelineprojec, Accessed 12/24/2020

Arjun Pennathur, MD et al, Stereotactic Radiosurgery for the Treatment of Lung Neoplasm: Experience in 100 Consecutive Patients Ann Thorac Surg 2009;88:1594-1600

H. C. Fernando, M. Schuchert, R. Landreneau, and B. T. Daly
Approaching the High-Risk Patient: Sublobar Resection, Stereotactic Body Radiation Therapy, or Radiofrequency Ablation Ann. Thorac. Surg., June 1, 2010; 89(6): S2123 – S2127.

Dunlap NE, Cai J, Biedermann GB, et al. Chest wall volume receiving >30 Gy predicts risk of severe pain and/or rib fracture after lung stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 2010; 76:796.

Andolino DL, Forquer JA, Henderson MA, et al. Chest wall toxicity after stereotactic body radiotherapy for malignant lesions of the lung and liver. Int J Radiat Oncol Biol Phys 2011; 80:692.

Haute Autorite de sante/French National Authority for Health (HAS). Value of extra-cranial stereotactic radiotherapy [summary]. Saint-Denis La Plaine, France: HAS; 2007.

American Society for Therapeutic Radiation and Oncology (ASTRO). The ASTRO/ACR Guide to Radiation Oncology Coding 2007. Fairfax, VA: ASTRO; 2007.

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