Computed Tomography-Guided Percutaneous Radiofrequency Ablation in Older Adults With Early-Stage Peripheral Lung Cancer: A Retrospective Cohort Study

Abstract

Objectives To evaluate the feasibility, safety, and efficacy of computed tomography(CT)-guided percutaneous radiofrequency ablation (RFA) in medically inoperable older adults with clinical stage I non-small cell lung cancer (NSCLC). Patients and Methods We retrospectively reviewed the records of medically inoperable older adults (≥70 years) with clinical stage I NSCLC who underwent percutaneous multi-tined electrode RFA at our institution between January 2014 and December 2018. We analyzed the patients’ characteristics, therapy response, survival, as well as the procedure-related complications. Results Eighteen patients (10 men and 8 women) with a mean age of 75.9 (71−85) years were treated in during the study period. The median tumor size was 25 mm (range, 19−43 mm); 10 and 8 cases involved stage T1 and T2a disease, respectively. The median follow-up duration was 25 (11–45) months. RFA was technically successful for all 18 lesions, with no treatment-related mortality. The disease control rate was 83.3% (15/18 lesions). There were 6 cases of pneumothorax: one symptomatic case requiring thoracic drainage, and five requiring no treatment. Minor complications, including pulmonary infection, chest pain, fever, and cough, were treated within 4 days (range, 1−4 days). The progression-free survival rates were 83.3%, 64.9%, and 51.9% 1, 2, and 3 years, respectively. The corresponding overall survival rates were 92.2%, 81.5%, and 54.3%, respectively. Conclusions CT-guided percutaneous RFA is safe and effective in medically inoperable patients with stage I NSCLC and could be an alternative therapeutic strategy, particularly in older adults with early-stage peripheral lung cancer.

Enhancing precision in lung tumor ablation through innovations in CT‐guided technique and angle control

“…To enhance the precision and safety of both RFA and MWA, our center developed the laser angle guide assembly (LAGA) system, an angle reference designed to improve accuracy and decrease complication rates associated with LPTA. LAGA greatly enhances the accuracy of preoperative computed tomography (CT)‐guided localizations, reducing the necessity for multiple puncture attempts 14,15 . In this single‐center study, we aimed to assess how LAGA impacted the efficacy and safety of LPTA.…”

“…LAGA greatly enhances the accuracy of preoperative computed tomography (CT)‐guided localizations, reducing the necessity for multiple puncture attempts. 14 , 15 In this single‐center study, we aimed to assess how LAGA impacted the efficacy and safety of LPTA.…”

Radiofrequency ablation for stage <IIB non‐small cell lung cancer: Opportunities, challenges, and the road ahead

“…Despite the fact that surgery is still the preferred course of action for patients with early‐stage non‐small cell lung cancer (NSCLC), the discipline of radiation oncology has had innumerable opportunities over the past 10 years to achieve high rates of local tumor control and cure 1 . At the same time, more patients are unable to receive surgical treatment due to poor lung function brought on by underlying lung diseases that coexist, more challenging secondary surgery as a result of recurrence, as well as physical and psychological factors 2 . For these individuals, CT‐guided percutaneous pulmonary radiofrequency ablation offers a more appropriate treatment option and NCCN guidelines recognize the use of this technique in high‐risk patients 3 …”

“…1 At the same time, more patients are unable to receive surgical treatment due to poor lung function brought on by underlying lung diseases that coexist, more challenging secondary surgery as a result of recurrence, as well as physical and psychological factors. 2 For these individuals, CT-guided percutaneous pulmonary radiofrequency ablation offers a more appropriate treatment option and NCCN guidelines recognize the use of this technique in high-risk patients. 3 Radiofrequency ablation (RFA), as the most common type of thermal ablation technique, was first applied in 1989 to treat supraventricular tachycardia and other cardiac electrical conduction diseases when medication proved ineffective.…”

Case report: Radiofrequency ablation combined with biopsy for Cushing’s syndrome due to ectopic ACTH lesions in the lung

“…Still, none of the above techniques can obtain pathological tissue for pathologic diagnosis. Imagingguided radiofrequency ablation has been applied to the treatment of tumors in various parts of the body, which has the advantages of precise localization, exact efficacy, minimal trauma, puncture biopsy can precisely cut and take the material for small lesions (7)(8)(9). Radiofrequency ablation with simultaneous biopsy for ectopic ACTH lesions in the lung has not been reported in the literature before.…”