Radiofrequency ablation for lung mets – pro
Lay Summary: Radiofrequency Ablation of lung mets requires more study before it can considered standard of care.
The lung is the most common site for primary cancer worldwide as well as being a common site of metastases for various malignancies. Percutaneous radiofrequency ablation (RFA) is rapidly evolving as a new minimally invasive tool for the treatment of pulmonary tumors(1.2). Although such early experience appears promising, many questions regarding patient selection, radiofrequency ablation technique, effectiveness of ablation on lung tumors, radiographic follow-up, and survival remain unanswered. There are a number of published reports of its effectiveness but no larger studies and guidelines (from NHS in the UK) restricts it to special patient circumstances(3).
Recently, several more studies and reviews have appeared. However, there are still no guidelines that routinely recommend this procedure.
It is still under study: Study of Outcomes of Radiofrequency Ablation of Lung Tumors, NCT00280189 .
The purpose of this study is to assess short and long term outcomes after radiofrequency ablation (RFA) of pulmonary malignancies in patients who are not candidates for surgical resection. This study will evaluate the efficacy of RFA for the treatment of lung tumors by assessing its impact on local tumor control, progression free survival, overall survival, dyspnea score and quality of life (QOL).
1.Steinke K, Sewell PE, Dupuy D, Lencioni R, Helmberger T, Kee ST, Jacob AL, Glenn DW, King J, Morris DL. Pulmonary radiofrequency ablation–an international study survey.Anticancer Res. 2004 Jan-Feb;24(1):339-43.
2.Christophe L. Nguyen, MD, Walter J. Scott, MD * , Melvyn Goldberg, MD Radiofrequency Ablation of Lung Malignancies Ann Thorac Surg 2006;82:365-371
3.http://www.nice.org.uk/download.aspx?o=ipg185guidance
Other references:
Zhu JC, Yan TD, Glenn D, Morris DL. Radiofrequency ablation of lung tumors: feasibility and safety. Ann Thorac Surg 2009; 87:1023.
Pennathur A, Abbas G, Qureshi I, et al. Radiofrequency ablation for the treatment of pulmonary metastases. Ann Thorac Surg 2009; 87:1030.
Chua TC, Thornbury K, Saxena A, et al. Radiofrequency ablation as an adjunct to systemic chemotherapy for colorectal pulmonary metastases. Cancer 2010; 116:2106.
Lencioni R, Crocetti L, Cioni R, et al. Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol 2008; 9:621.
Zemlyak A, Moore WH, Bilfinger TV. Comparison of survival after sublobar resections and ablative therapies for stage I non-small cell lung cancer. J Am Coll Surg 2010; 211:68.