Abstract
Lobar resection has been the established standard of care for peripheral early-stage
non—small cell lung cancer (NSCLC). Over the last few years, surgical lung sparing
approach (sublobar resection [SLR]) has been compared with lobar resection in T1N0
NSCLC. Three nonsurgical options are available in those patients who have a prohibitive
surgical risk, and those who refuse surgery: stereotactic body radiotherapy (SBRT),
percutaneous ablation, and bronchoscopic ablation. Local ablation involves placement
of a probe into a tumor, and subsequent application of either heat or cold energy,
pulsing electrical fields, or placement of radioactive source under an image guidance
to create a zone of cell death that encompasses the targeted lesion and an ablation
margin. Despite being in their infancy, the bronchoscopic ablative techniques are
undergoing rapid research, as they extrapolate a significant knowledge-base from the
percutaneous techniques that have been in the radiologist's armamentarium since 2000.
Here, we discuss selected endoscopic and percutaneous thermal and non-thermal therapies
with the focus on their efficacy and safety.
Keywords
microwave ablation - radiofrequency ablation - non—small cell lung cancer - percutaneous
- bronchoscopy - CT-guided - outcomes
