Download PDF
Semin intervent Radiol 2013; 30(02): 151-156
DOI: 10.1055/s-0033-1342956
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lung Cancer Ablation: What Is the Evidence?

Thierry de Baere
1   Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France
,
Geoffroy Farouil
1   Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France
,
Frederic Deschamps
1   Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France
› Author Affiliations
Further Information

Publication History

Publication Date:
28 May 2013 (online)

Also available at
    Permissions and Reprints

Abstract

Percutaneous ablation of small non–small cell lung cancer (NSCLC) has been demonstrated to be both feasible and safe in nonsurgical candidates. Radiofrequency ablation (RFA), the most commonly used technique for ablation, has a reported rate of complete ablation of ~90%, with best results obtained in tumors <2 to 3 cm in diameter. The best reported 1-, 3-, and 5-year overall survival rates after RFA of NSCLC are 97.7%, 72.9%, and 55.7%, respectively. It is noteworthy that in most studies, cancer-specific survival is greater than overall survival due to severe comorbidities in patients treated with RFA for NSCLC. Aside from tumor size and tumor stage, these comorbidities are predictive of survival. Other ablation techniques such as microwave and irreversible electroporation may in the future prove to overcome some of the limitations of RFA, namely for large tumors or tumors close to large vessels. Stereotactic body radiation therapy has also been demonstrated to be highly efficacious in treating small lung tumors and will need to be compared with percutaneous ablation. This article reviews the current evidence regarding RFA for lung cancer.

Keywords

lung cancer - non–small cell lung cancer - radiofrequency ablation - interventional radiology
 

  • References

  • 1 McGarry RC, Song G, des Rosiers P, Timmerman R. Observation-only management of early stage, medically inoperable lung cancer: poor outcome. Chest 2002; 121 (4) 1155-1158
    CrossrefPubMedSearch in Google Scholar
  • 2 Goldberg SN, Gazelle GS, Compton CC, McLoud TC. Radiofrequency tissue ablation in the rabbit lung: efficacy and complications. Acad Radiol 1995; 2 (9) 776-784
    CrossrefPubMedSearch in Google Scholar
  • 3 Jaskolka JD, Kachura JR, Hwang DM , et al. Pathologic assessment of radiofrequency ablation of pulmonary metastases. J Vasc Interv Radiol 2010; 21 (11) 1689-1696
    CrossrefPubMedSearch in Google Scholar
  • 4 Ahmed M, Liu Z, Afzal KS , et al. Radiofrequency ablation: effect of surrounding tissue composition on coagulation necrosis in a canine tumor model. Radiology 2004; 230 (3) 761-767
    CrossrefPubMedSearch in Google Scholar
  • 5 Zhu JC, Yan TD, Morris DL. A systematic review of radiofrequency ablation for lung tumors. Ann Surg Oncol 2008; 15 (6) 1765-1774
    CrossrefPubMedSearch in Google Scholar
  • 6 de Baère T, Palussière J, Aupérin A , et al. Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology 2006; 240 (2) 587-596
    CrossrefPubMedSearch in Google Scholar
  • 7 Gillams AR, Lees WR. Radiofrequency ablation of lung metastases: factors influencing success. Eur Radiol 2008; 18 (4) 672-677
    CrossrefPubMedSearch in Google Scholar
  • 8 Hiraki T, Sakurai J, Tsuda T , et al. Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors: evaluation based on a preliminary review of 342 tumors. Cancer 2006; 107 (12) 2873-2880
    CrossrefPubMedSearch in Google Scholar
  • 9 Okuma T, Matsuoka T, Yamamoto A , et al. Determinants of local progression after computed tomography-guided percutaneous radiofrequency ablation for unresectable lung tumors: 9-year experience in a single institution. Cardiovasc Intervent Radiol 2010; 33 (4) 787-793
    CrossrefPubMedSearch in Google Scholar
  • 10 Lencioni R, Crocetti L, Cioni R , et al. Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol 2008; 9 (7) 621-628
    CrossrefPubMedSearch in Google Scholar
  • 11 Lee JM, Jin GY, Goldberg SN , et al. Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology 2004; 230 (1) 125-134
    CrossrefPubMedSearch in Google Scholar
  • 12 Anderson EM, Lees WR, Gillams AR. Early indicators of treatment success after percutaneous radiofrequency of pulmonary tumors. Cardiovasc Intervent Radiol 2009; 32 (3) 478-483
    CrossrefPubMedSearch in Google Scholar
  • 13 Giraud P, Antoine M, Larrouy A , et al. Evaluation of microscopic tumor extension in non-small-cell lung cancer for three-dimensional conformal radiotherapy planning. Int J Radiat Oncol Biol Phys 2000; 48 (4) 1015-1024
    CrossrefPubMedSearch in Google Scholar
  • 14 Hiraki T, Gobara H, Mimura H , et al. Does tumor type affect local control by radiofrequency ablation in the lungs?. Eur J Radiol 2010; 74 (1) 136-141
    CrossrefPubMedSearch in Google Scholar
  • 15 Planché O, Teriitehau C, Boudabous S , et al. In vivo evaluation of lung microwave ablation in a porcine tumor mimic model. Cardiovasc Intervent Radiol 2013; 36 (1) 221-228
    CrossrefPubMedSearch in Google Scholar
  • 16 Wolf FJ, Grand DJ, Machan JT, Dipetrillo TA, Mayo-Smith WW, Dupuy DE. Microwave ablation of lung malignancies: effectiveness, CT findings, and safety in 50 patients. Radiology 2008; 247 (3) 871-879
    CrossrefPubMedSearch in Google Scholar
  • 17 Hiraki T, Gobara H, Takemoto M , et al. Percutaneous radiofrequency ablation combined with previous bronchial arterial chemoembolization and followed by radiation therapy for pulmonary metastasis from hepatocellular carcinoma. J Vasc Interv Radiol 2006; 17 (7) 1189-1193
    CrossrefPubMedSearch in Google Scholar
  • 18 Anai H, Uchida BT, Pavcnik D , et al. Effects of blood flow and/or ventilation restriction on radiofrequency coagulation size in the lung: an experimental study in swine. Cardiovasc Intervent Radiol 2006; 29 (5) 838-845
    CrossrefPubMedSearch in Google Scholar
  • 19 de Baere T, Robinson JM, Rao P, Teriitehau C, Deschamps F. Radiofrequency ablation of lung metastases close to large vessels during vascular occlusion: preliminary experience. J Vasc Interv Radiol 2011; 22 (6) 749-754
    CrossrefPubMedSearch in Google Scholar
  • 20 Brace CL. Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences?. Curr Probl Diagn Radiol 2009; 38 (3) 135-143
    CrossrefPubMedSearch in Google Scholar
  • 21 Brace CL, Hinshaw JL, Laeseke PF, Sampson LA, Lee Jr FT. Pulmonary thermal ablation: comparison of radiofrequency and microwave devices by using gross pathologic and CT findings in a swine model. Radiology 2009; 251 (3) 705-711
    CrossrefPubMedSearch in Google Scholar
  • 22 Crocetti L, Bozzi E, Faviana P , et al. Thermal ablation of lung tissue: in vivo experimental comparison of microwave and radiofrequency. Cardiovasc Intervent Radiol 2010; 33 (4) 818-827
    CrossrefPubMedSearch in Google Scholar
  • 23 Davalos RV, Mir IL, Rubinsky B. Tissue ablation with irreversible electroporation. Ann Biomed Eng 2005; 33 (2) 223-231
    CrossrefPubMedSearch in Google Scholar
  • 24 Deodhar A, Dickfeld T, Single GW , et al. Irreversible electroporation near the heart: ventricular arrhythmias can be prevented with ECG synchronization. AJR Am J Roentgenol 2011; 196 (3) W330-5
    PubMedSearch in Google Scholar
  • 25 Dupuy DE, Aswad B, Ng T. Irreversible electroporation in a swine lung model. Cardiovasc Intervent Radiol 2011; 34 (2) 391-395
    CrossrefPubMedSearch in Google Scholar
  • 26 Kingham TP, Karkar AM, D'Angelica MI , et al. Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg 2012; 215 (3) 379-387
    CrossrefPubMedSearch in Google Scholar
  • 27 Martin II RC, McFarland K, Ellis S, Velanovich V. Irreversible electroporation therapy in the management of locally advanced pancreatic adenocarcinoma. J Am Coll Surg 2012; 215 (3) 361-369
    CrossrefPubMedSearch in Google Scholar
  • 28 Usman M, Moore W, Talati R, Watkins K, Bilfinger TV. Irreversible electroporation of lung neoplasm: a case series. Med Sci Monit 2012; 18 (6) CS43-CS47
    CrossrefPubMedSearch in Google Scholar
  • 29 Joskin J, De Baère T, Tselikas L , et al. Irreversible electroporation of lung metastases: initial experience. Paper presented at: Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Annual Meeting; September 15–19, 2012; Lisbon, Portugal. Abstract 14051
    PubMed
  • 30 Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 2000; 174 (1) 57-59
    CrossrefPubMedSearch in Google Scholar
  • 31 Simon CJ, Dupuy DE, DiPetrillo TA , et al. Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology 2007; 243 (1) 268-275
    CrossrefPubMedSearch in Google Scholar
  • 32 Kodama H, Yamakado K, Takaki H , et al. Lung radiofrequency ablation for the treatment of unresectable recurrent non-small-cell lung cancer after surgical intervention. Cardiovasc Intervent Radiol 2012; 35 (3) 563-569
    CrossrefPubMedSearch in Google Scholar
  • 33 Palussière J, Lagarde P, Deschamps F , et al. Radiofrequency ablation of non-small-cell lung carcinoma. CVIR 2011; 34: 530
    PubMedSearch in Google Scholar
  • 34 Simon TG, Beland MD, Machan JT, Dipetrillo T, Dupuy DE. Charlson Comorbidity Index predicts patient outcome, in cases of inoperable non-small cell lung cancer treated with radiofrequency ablation. Eur J Radiol 2012; 81 (12) 4167-4172
    CrossrefPubMedSearch in Google Scholar
  • 35 Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (5) 373-383
    CrossrefPubMedSearch in Google Scholar
  • 36 Zemlyak A, Moore WH, Bilfinger TV. Comparison of survival after sublobar resections and ablative therapies for stage I non-small cell lung cancer. J Am Coll Surg 2010; 211 (1) 68-72
    CrossrefPubMedSearch in Google Scholar
  • 37 Kim SR, Han HJ, Park SJ , et al. Comparison between surgery and radiofrequency ablation for stage I non-small cell lung cancer. Eur J Radiol 2012; 81 (2) 395-399
    CrossrefPubMedSearch in Google Scholar
  • 38 Tada A, Hiraki T, Iguchi T , et al. Influence of radiofrequency ablation of lung cancer on pulmonary function. Cardiovasc Intervent Radiol 2012; 35 (4) 860-867
    CrossrefPubMedSearch in Google Scholar
  • 39 Kashima M, Yamakado K, Takaki H , et al. Complications after 1000 lung radiofrequency ablation sessions in 420 patients: a single center's experiences. AJR Am J Roentgenol 2011; 197 (4) W576-80
    PubMedSearch in Google Scholar
  • 40 Hess A, Palussière J, Goyers JF, Guth A, Aupérin A, de Baère T. Pulmonary radiofrequency ablation in patients with a single lung: feasibility, efficacy, and tolerance. Radiology 2011; 258 (2) 635-642
    CrossrefPubMedSearch in Google Scholar
  • 41 Grieco CA, Simon CJ, Mayo-Smith WW, DiPetrillo TA, Ready NE, Dupuy DE. Percutaneous image-guided thermal ablation and radiation therapy: outcomes of combined treatment for 41 patients with inoperable stage I/II non-small-cell lung cancer. J Vasc Interv Radiol 2006; 17 (7) 1117-1124
    CrossrefPubMedSearch in Google Scholar
  • 42 Hakimé A, Hines-Peralta A, Peddi H , et al. Combination of radiofrequency ablation with antiangiogenic therapy for tumor ablation efficacy: study in mice. Radiology 2007; 244 (2) 464-470
    CrossrefPubMedSearch in Google Scholar