CLINICAL APPLICATION AND ADVANCES IN RADIOFREQUENCY ABLATION OF LUNG CANCER

Abstract

Radiofrequency ablation is a safe and relatively straightforward minimally invasive procedure for the treatment of lung cancers. RF therapy can potentially be used as an adjuvant therapy to systemic anticancer treatment, including chemotherapy or chemotherapy and radiation therapy, to decrease the tumor cell volume with reasonably low morbidity and mortality. Furthermore, it could be a powerful alternative to surgical treatment or chemotherapy, particularly in selected patients with tumors smaller than 3.0 cm in diameter who have combined medical illnesses or limited functional lung reserve. Chest wall involvement by either primary lung cancer or metastatic deposits is common. Large chest wall tumors are difficult to treat with radiation therapy alone, and many patients with intractable pain have already received the maximal dose of radiation. Palliation with narcotics is difficult in patients with large, painful tumors that continue to grow; affected patients often spend the last months of their lives with inadequate analgesia. Therefore, the use of a minimally invasive alternative such as RF ablation to reduce tumor volume or provide local palliation may be beneficial in these patients. RFA is not intended to replace surgery, radiation therapy or chemotherapy in all patients. It may be effective when used alone or in conjunction with these treatments. RFA is considered a relatively safe procedure with an extremely low mortality rate or major complications in form of sever pneumothorax that necessitates intubation. With refinements in technology, patient selection, clinical applications, and methods of follow-up, RFA will continue to flourishes a potentially viable stand-alone or complementary therapy for both primary and secondary lung malignancies in standard and high-risk populations. New energy sources such as microwave ablation may result in improved energy delivery and primary control rates.