Radiofrequency Ablation for Early-Stage Nonsmall Cell Lung Cancer

Hiraki, Takao; Gobara, Hideo; Iguchi, Toshihiro; Fujiwara, Hiroyasu; Matsui, Yusuke; Kanazawa, Susumu

doi:10.1155/2014/152087

Cited by 43 publications

(43 citation statements)

References 58 publications

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“…Although our study consisted of limited number of patients with NSCLC, our overall survival outcomes were similar to those reports. LTP after RF ablation was reported to be higher than after sublobar resection and SBRT (14), which was similar to our study.…”

Section: Discussionsupporting

confidence: 92%

“…Indeed, in the review study of Hiraki et al (14), one-, two-, three-, and five-year overall survival rates after RF ablation of stage I NSCLC were reported as 78%-100%, 53%-86%, 36%-88%, and 25%-61%, respectively. In another previously published systematic review of RF ablation for lung tumors including 17 studies, Zhu et al (15) reported that one-, two-, and three-year survival rates ranged between 63%-85%, 55%-65%, and 15%-46%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

Akhan¹,

Güler²,

Akıncı³

et al. 2015

Diagn Interv Radiol

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P rimary lung cancer is the leading cause of cancer-related death worldwide (1). Treatment of primary lung cancers includes surgical resection, radiation therapy, chemotherapy, and thermal ablation. Surgical resection remains the treatment of choice for patients with early stage non-small cell lung cancer (NSCLC) (2). However, primary lung cancers are generally diagnosed in advanced stages. Moreover, due to the high incidence of associated comorbidities and limited pulmonary reserve, most patients are considered ineligible for surgery (3,4).In addition to primary cancers, lungs are the second most frequent site of metastatic disease. In selected patients with metastatic lung cancer, surgical resection is the preferred treatment. However, even patients who have undergone a complete resection have a high incidence of recurrence and may require multiple surgeries (5). Repeat thoracotomy leads to further removal of functional pulmonary tissue. Surgical resection might not be possible in patients with certain comorbidities and limited pulmonary reserve.Patients with pulmonary colorectal metastases constitute a significant portion of metastatic lung tumor group. Approximately 10% of patients with colorectal cancer develop pulmonary metastases during the course of disease (6). It has been reported that in patients with limited colorectal pulmonary metastases and no extrapulmonary disease, five-year survival following surgical resection is approximately 35%-45% (7). However, many patients are not suitable candidates for surgery. PURPOSEWe aimed to evaluate the survival benefit achieved with radiofrequency (RF) ablation of primary and metastatic lung tumors and determine significant prognostic factors for recurrence-free survival. METHODSForty-nine patients with lung cancer (10 primary and 39 metastatic) underwent computed tomography-guided percutaneous RF ablation between June 2005 and October 2013. A total of 112 tumors (101 metastatic and 11 primary non-small cell lung cancer) were treated with RF ablation. Tumor diameter ranged from 0.6 to 4 cm (median 1.5 cm). Effectiveness of treatment, complications, and survival were analyzed. RESULTSPrimary success rate was 79.5% and local tumor progression occurred in 23 tumors. Among tumors showing progression, 10 were re-treated with RF ablation and secondary success rate was 87.5%. One-, two-, and three-year overall survival rates of 10 patients with primary lung cancer were 100%, 86%, and 43%, respectively. One-, two-, three-, four-, and five-year overall survival rates for 39 patients with metastatic lung tumors were 90%, 73%, 59%, 55%, and 38%, respectively. One-, two-, three-, and four-year overall survival rates for 16 patients with colorectal pulmonary metastases were 94%, 80%, 68%, and 23%, respectively. Complications occurred in 30 sessions (24.6%). Pneumothorax occurred in 19 sessions with seven requiring image-guided percutaneous chest tube drainage. Tumor status (solitary or multiple) and presence of extrapulmonary metastasis at initial RF ablation were significa...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

Akhan¹,

Güler²,

Akıncı³

et al. 2015

Diagn Interv Radiol

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show abstract

“…However, some patients cannot undergo surgery because of poor respiratory function, advanced age, or comorbid disease. Recently, radiofrequency ablation (RFA) of the lung for patients who are not surgical candidates has been reported to achieve comparable results to surgical resection [11][12][13][14][15][16][17][18][19]. However, the availability of this treatment in Japan and re- ports on its outcomes from this country are limited because of lack of coverage within the national health insurance system.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Utility and Safety of Radiofrequency Ablation for Malignant Lung Tumors: Preliminary Results

Hasegawa

Sato

Inaba

et al. 2017

Interventional Radiology

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Purpose: We evaluated the clinical usefulness and safety of radiofrequency ablation (RFA) for the treatment of lung tumors.Materials and Methods: This retrospective study included patients who underwent RFA for the treatment of lung tumors at our institution from March 2006 to April 2015. Technical success, safety, local tumor progression, and survival were evaluated.Results: In total, 41 patients (28 men and 13 women; median age, 69 years; range 37-88 years) with 51 malignant lung tumors measuring 0.6-6.8 cm (mean, 1.71.2 cm) completed 46 planned RFA sessions. Lung tumors were primary in 22 patients and metastatic in 19 patients. Four tumors were not completely surrounded by an ablation zone on computed tomography immediately after RFA (technical success rate; 91.3%, 42/46). One of 41 patients (2.4%) died of pneumonia in the contralateral lung 26 days after RFA. Grade 2 symptomatic pneumothorax (n = 5) and hemothorax (n = 1) and grade 1 asymptomatic pneumothorax (n = 9) occurred during the procedure. Grade 3 pneumonia (n = 1) and grade 2 fever (n = 2) occurred within 30 days of follow-up. During a mean follow-up period of 20.319.1 months, local tumor progression developed in 8 of 51 tumors (15.7%). Eleven patients (26.8%) died of cancer progression (n = 9) or pneumonia (n = 2). The 5-year overall survival rate was 53.5% (95% confidence interval, 31.1-75.9%). Tumor size was a significant prognostic factor on Cox proportional hazards analysis.Conclusion: RFA was a safe and useful treatment option for malignant lung tumors.

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“…In addition, several studies have shown that RFA was as effective as surgical resection in selected patients with primary pulmonary tumors (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

A prospective clinical trial of radiofrequency ablation for pulmonary metastases

Wang

Xia

Wang

et al. 2015

Molecular and Clinical Oncology

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Abstract. Pulmonary oligometastases can be treated by local treatment options, such as resection, radiofrequency ablation (RFA), and radiotherapy, in selected patients. In the present study, 67 patients with 115 pulmonary metastases were treated, and all the lesions were treated by RFA and followed with a computed tomography scan. The local control, overall survival (OS), progression-free survival (PFS) and treatment-related toxicity were observed. Median follow-up duration after the initial RFA was 24 months (range, 3-39 months). The median PFS from RFA was 14 months [95% confidence interval (CI), 11.6-16.4]. The 6-, 12-and 18-month PFS rates were 82.1, 55.7 and 27.5%, respectively. The median OS rate from RFA was 24 months (95% CI, 18.2-29.8). The 1-, 2-and 3-year OS rates were 83.6, 46.3 and 14.3%, respectively. Primary tumor was significantly correlated to PFS and OS on multivariate analysis, and other variates showed no significance. Therefore, RFA is safe for patient treatment and can be considered as a promising treatment option for patients with pulmonary metastases. IntroductionThe lung is a main site of metastatic disease for the majority of solid tumors and local treatments have been playing an emerging role in combination with systemic therapies. In oligometastatic (1-3 pulmonary nodules) and clinically selected patients (good performance status and absent or stable extra-thoracic disease), surgery can be considered as the standard option, with good results in terms of local control and survival rate (1).Patients with pulmonary metastases often receive multiple surgeries due to the fact that not all the metastatic disease is Wdetectable at first presentation and the high likelihood of recurrence. Therefore, invasive therapies have been explored to treat patients with oligometastatic disease in an effort to improve the long-term survival rate and quality of life in patients who are not able to undergo surgery. Radiofrequency ablation (RFA) is one such technique that generates tissue heating to necrose tumors in situ and has been proved to be safe and effective in treating selected patients with certain solid tumors unsuitable for surgical resection (2).In addition, several studies have shown that RFA was as effective as surgical resection in selected patients with primary pulmonary tumors (3-5). Patients and methods Patient characteristics.Between January 2011 and September 2014, 67 patients with 115 lung metastases were enrolled in the prospective trial. Patient characteristics are listed in Table I. The decision to perform RFA was made by a multidisciplinary team and approved by the Ethics Committee of the Fudan University Shanghai Cancer Center and the patients.The selection criteria for RFA were: i) 1-3 lung metastases at the treatment time, with a maximum tumor diameter <50 mm; ii) minimum distance was 10 mm apart from the big trachea, primary bronchi, esophagus, great vessels and heart; iii) medically inoperable or patients refused surgery; iv) absent or controlled extra-thoracic disease [at com...

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Radiofrequency Ablation for Early-Stage Nonsmall Cell Lung Cancer

Cited by 43 publications

References 58 publications

Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

Radiofrequency ablation for lung tumors: outcomes, effects on survival, and prognostic factors

The Clinical Utility and Safety of Radiofrequency Ablation for Malignant Lung Tumors: Preliminary Results

A prospective clinical trial of radiofrequency ablation for pulmonary metastases

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