P2.28: Image-Guided Radiofrecuency Ablation of Lung Metastases. A Single Cancer Center Experience in Panama

Abstract

Method: According to lung CT designed plan of percutaneous inoculation zone, 16G guiding needle was advanced into appropriate location. Two fresh CTVT tumor fragments (2.0mm) was transmitted into lung parenchyma directly. All six beagles were followed up by CT scan. After ten weeks, these dogs underwent sequentially bronchial artery digital subtraction angiography (BA-DSA), bronchial arteries CT(BA-CT) and trans-pulmonary arterial Lipiodol CT which CT scanned after pulmonary artery were embolized with Lipiodol. Results:The technical success rate of improved CTVT lung model achieved 100%(6/6). Maximum diameters of tumor growth in different time were recorded on Table 1. Total 25 nodules were found in all the beagle lungs. 9 nodules were in left lungs versus 16 in right. The typical case was shown on Figure 1. For 14 nodules larger than 2cm, imaging showed visible dilated bronchial artery leading to the tumor direction on the BA-DSA (Figure 2, limitation of abstract). In these beagles which pulmonary arteries were embolized with Lipiodol, two lesions (<1cm) were displayed with Lipiodol deposition, while a droplet-shaped Lipiodol deposition can be seen in one nodule over 2cm (Figure 3, limitation of abstract). Figure 1. The typical CTVT model CT imagingConclusion: It is found that tumor blood supplement is related to tumor size in CTVT lung tumor model. The bigger the tumor size was, the greater likelihood of bronchial artery was. The closer centrally located, the more likely supplied by bronchial artery. This improved model can also be used for evaluation of outcomes about various therapy methods and precision treatment.Background: Pulmonary metastatic lesions are present in 20e54% of all patients who die of cancer. Surgical studies have shown that local management of distant tumor metastasis as part of multimodal cancer therapy improves survival. Image-guided percutaneous radiofrequency ablation (RFA) has been proposed as an efficacious local therapy for lung metastases in nonsurgical candidates. Minimally invasive procedures are still to prove their clinical relevance. Method: We performed a retrospective review of patients treated with RFA between 2013 and 2016. Demographic, clinical, therapeutic and prognostic variable were studied. Progression free survival was evaluated using Kaplan Meier method. Results: We analyzed 20 patients, 10 men and 10 women. Median age 63 years old. ECOG 0 in 9 patients and ECOG 1 in 11 patients. 30% Colon Cancer, 25% rectal cancer, 15% Head and Neck Cancer were most common primary sites. 65% with less than 2 lesions. 45% chemotherapy, 40% chemo radiotherapy, 10% radiotherapy and 5% surgery were received as previous treatment. 85% without extra pulmonary metastases. Median size of lesions was 20 mm. Median time from diagnosis to procedure was 29 months. 75% overall respond to RFA and 15% died. Response Rate was 57.6%, 31.6% complete response, 26% partial response, 31.6% stable disease and 10.5% progression were registered. 30% Complication rate, 3 patients with pneumothorax, 2 pleura...