Long-Term Results of Radiofrequency Ablation Treatment of Stage I Non-small Cell Lung Cancer: A Prospective Intention-to-Treat Study

Ambrogi, Marcello Carlo; Fanucchi, Olivia; Cioni, Roberto; Dini, P.; Liperi, Annalisa De; Cappelli, Carla; Davini, Federico; Bartolozzi, Carlo; Mussi, Alfredo

doi:10.1097/jto.0b013e31822d538d

Cited by 133 publications

(115 citation statements)

References 34 publications

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“…(17). Despite a possible transient decrease during the first 3 weeks after ablation, the overall respiratory function tested at 3, 6 or 12 months after the intervention shows no degradation (25,41,42,47). …”

Section: Complicationsmentioning

confidence: 99%

“…After ablation, cancer-related survival is the order of 83-93% at 1 year, 68-75% at 2 years and 59-61% at 3 years (25,47,48). Prospective controlled studies are still needed to definitely assess the role of ablation.…”

Section: A B Cmentioning

confidence: 99%

“…Complications are usually minor and major encouraging. Repeated ablations improve local control in patients showing a persistence of viable tumor tissue (2,25,46). majority of patients treated with ablation have contraindications to other treatments, which makes the results of ablative therapy even more A B C to the manipulation of the needle than the thermal ablation itself, since it has a cauterizing effect (with the exception of cryotherapy).…”

Section: Complicationsmentioning

confidence: 99%

“…The ideal target lesion for ablation is a lesion measuring less than 3 cm diameter, and not in contact with large vessels or bronchi, mediastinum and chest wall (2,13,(24)(25)(26)(27)(28)(29)(30).…”

Section: Indicationsmentioning

confidence: 99%

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Percutaneous ablation of malignant thoracic tumors

Ghaye

2013

Journal of the Belgian Society of Radiology

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Lung cancer is the leading cause of death related to cancer. Fifteen to thirty percent of patients with a localized lung cancer are actually inoperable as they present with poor general condition, limited cardiopulmonary function, or a too high surgical risk. Therefore, minimally invasive treatments are needed and percutaneous ablation seems an attractive option. Thermal ablation can be performed by delivering heat (radiofrequency, microwave, laser) or cold (cryotherapy) through a needle inserted into the tumor under CT guidance. The ideal lesion is less than 2 or 3 cm in diameter. Success of percutaneous thermal ablation appears to be close to those of surgery for localized lung cancer. Nevertheless studies are still needed to definitely assess the role of ablation compared to other emerging techniques, as stereo tactic radiotherapy as well as potential synergy with other treatments.

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Section: Complicationsmentioning

confidence: 99%

Section: A B Cmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Indicationsmentioning

confidence: 99%

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Percutaneous ablation of malignant thoracic tumors

Ghaye

2013

Journal of the Belgian Society of Radiology

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“…The level of evidence for ablation procedures in the treatment of malignant lung tumors is low and is currently based on case series, descriptive comparative studies, and single-arm prospective studies (5)(6)(7)(8)(9). No randomized controlled trials comparing percutaneous ablation and percutaneous radiotherapy or limited surgical resection have yet been published.…”

mentioning

confidence: 99%

Thermal Ablation of Malignant Lung Tumors

Schneider

Herth²,

Dienemann³

2013

Deutsches Ärzteblatt International

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SUMMARYBackground: About 50 000 new cases of non-small-cell carcinoma of the lung are diagnosed in Germany each year. More than 20% of the affected patients cannot be offered radical resection because of comorbidity alone. The lung is also the second most common site of distant metastases of extrathoracic tumors; it is the only site of such metastases in 20% of cases. In recent years, image-guided thermoablation has been used with increasing frequency in patients who are unable to undergo surgery for medical reasons.

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Radiofrequency ablation of stage IA non–small cell lung cancer in medically inoperable patients: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial

Dupuy

Fernando

Hillman

et al. 2015

Cancer

189

147

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Purpose This study evaluates the two-year overall survival (OS), adverse event rate, local control rate and impact on pulmonary function tests (PFTs) in medically inoperable patients with stage IA NSCLC undergoing CT-guided RFA in a prospective multi-center trial. Methods 54 patients M:F=25:29, median age/range= 76/60–89 were enrolled from 16 US centers 51 patients were eligible (biopsy proven stage IA NSCLC and deemed medically inoperable by board certified thoracic surgeon) for evaluation. PFTs were obtained within 60 days of RFA, 3 and 24 months after RFA. Adverse events were recorded and categorized. Patients were followed by CT and FDG PET. Local control rate and recurrence patterns were analyzed. RESULTS The OS rate was 86.3% at one year and 69.8% at two years. Local tumor recurrence free rate was 68.9% at one year and 59.8% at two years and was worse for tumors >2 cm. In the 19 patients with local recurrence, 11 had retreatment with RFA, nine had radiation and three had chemotherapy. There were 21 grade 3, two grade 4 and one grade 5 AEs in 12 patients within the first 90 days after RFA. None of the grade 4 and 5 AEs were attributed to the RFA. There was no significant change in the FEV1 or DLCO after RFA. Tumor size less than 2.0 cm and performance status of 0–1 were associated with a statistically significant improved survival of 83% and 78% respectively, at two years. CONCLUSIONS RFA is a single minimally invasive procedure, that is well tolerated in medically inoperable patients, does not adversely affect PFTs and gives two year OS that is comparable to that reported following SBRT in similar patients.

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Long-Term Results of Radiofrequency Ablation Treatment of Stage I Non-small Cell Lung Cancer: A Prospective Intention-to-Treat Study

Abstract: Radiofrequency ablation treatment of early-stage NSCLC seems to be a effective minimally invasive therapy even in the long-term period, particularly for stage Ia tumors.

Cited by 133 publications

References 34 publications

Percutaneous ablation of malignant thoracic tumors

Percutaneous ablation of malignant thoracic tumors

Thermal Ablation of Malignant Lung Tumors

Radiofrequency ablation of stage IA non–small cell lung cancer in medically inoperable patients: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial

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