Image-guided radiofrequency ablation shows promise for patients with lung cancer who are poor surgical candidates
Lung cancer patients who are poor candidates
for surgery have a new alternative with image-guided radiofrequency
ablation, according to a presentation at the annual meeting of the
Radiological Society of North America (RSNA).
"Experience leads me to believe that
as lung cancer detection improves, we eventually will be able to
avoid surgery by eradicating early-stage lung cancer with minimally
invasive means," said presenter Damian Dupuy, MD.
Dupuy and his American colleagues studied
155 image-guided radiofrequency ablation lung procedures over 6
years on 126 medically inoperable patients who had a total of 163
lesions. The technique uses a specially designed needle connected
to a radiofrequency generator that delivers electrical current to
ablate tumors. Computed tomography or ultrasound is used to guide
the needle to the tumor site.
"Although the patients we treated were
poor surgical candidates, the procedures went very well," Dupuy
said. "Our complication rate was low, and morbidity and mortality
rates were lower than those of lung surgery. Plus, radiofrequency
ablation is an outpatient procedure with a tremendously condensed
recovery period."
Approximately 174,000 Americans are diagnosed
with lung cancer each year, according to the American Cancer Society,
but. Dupuy said surgery is not an option for the majority. In many
cases the disease is too extensive for surgical removal, or there
is an underlying disease such as emphysema, heart disease or other
medical problems. Traditionally, these patients are treated with
chemotherapy or radiation.
Dupuy and his colleagues determined that
ablation alone or in conjunction with chemotherapy and radiation
therapy is safe and feasible for treatment of primary lung tumors
and tumors that metastasize from other parts of the body.
"The outpatient radiofrequency ablation
procedure effectively controls small tumors, allowing these patients
to avoid surgery," Dupuy said.
The technique is particularly beneficial
for patients who have a lung cancer recurrence or regrowth and cannot
have additional surgery or radiation therapy, Dupuy said.
"Ablation can relieve pain and control
local symptoms in these patients," Dupuy said. "It does
not necessarily extend their lives, but it can improve their quality
of life."
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