CHICAGO - Image-guided radiofrequency ablation (RFA) is a viable treatment option for lung cancer patients who are not good candidates for surgery, according to results from a series of 126 lung cancer patients treated with RFA.
Moreover, RFA offers several distinct advantages over traditional cancer treatments such as radiation and chemotherapy, according to Dr. Damian Dupuy, a professor of diagnostic imaging at Brown Medical School in Providence, RI. Dupuy reported his findings Wednesday at the RSNA meeting. "Unlike radiation, there is no maximum dose of RFA, so the procedure can be repeated a number of times," he said. "And a treatment costs about the same as a single cycle of chemotherapy."
The study included 126 patients who had a total of 163 lesions, of which 155 were treated with RFA.
Sixty-nine of the patients were men, and the average age of patients was 68. "On average the tumors were 3.3 cm, which is just over an inch in diameter, but we treated tumors up to 19 cm in diameter," Dupuy said.
Another advantage of RFA is that it can be used in conjunction with other treatments, he said. For example, in this study 37 patients also had conventional radiation therapy, and 14 had radioactive seeds implanted in the tumors, a procedure called brachytherapy.
In addition to using RFA as a curative treatment, it can also be used to relieve pain for patients with late-stage, terminal lung cancer. In his study, 20 patients received RFA for this palliative treatment, and 106 had RFA for local control. Most of the 106 patients had the tumor successfully ablated with a single treatment, but 21 patients needed two treatments, one patient required three treatments, and two patients needed four treatments.
In this study only patients who were not good candidates for surgery were treated. According to Dupuy, that criteria covers a majority of lung cancer patients who are often too old or who have other smoking-related conditions, such as heart disease or chronic obstructive pulmonary disease (COPD) to survive surgery. "But RFA can even be done in very old patients," he said. He noted that one of his patients was 92 when he underwent RFA for a lung tumor. "We had to repeat the procedure a year later -- when the patient was 93 -- and now he is 95 and still leading a very active life."
He stated that 62% of the patients who had treatable disease were still alive at 21months after surgery, and "at five years more than half of the patients are still alive."
Dupuy received grant support from Valley Lab, Vivant Medical, and Boston Scientific.
By M.M. Pennell
AuntMinnie.com contributing writer
December 1, 2004
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