Combined Therapy May Treat Lung Cancer
Radiofrequency Ablation and Traditional Radiation Could Help Inoperable Patients
July 17, 2006 -- An experimental treatment that uses heat to kill tumors appears to help in prolonging the lives of early-stage lung cancer patients who can't have surgery.
The average three-year survival among 41 patients treated with radiofrequency ablation (RFA) combined with traditional radiation therapy was 3.5 years. That is longer than survival typically seen among similar patients treated with radiation therapy alone, interventional radiologist and RFA pioneering researcher Damian Dupuy, MD, tells WebMD.
Only about 60 lung cancercancer patients worldwide have been treated with the combination of RFA and radiation, but Dupuy says their results suggest that the two treatments provide better results than either therapy alone.
"I have been all over the world within the last five years telling this story," he says. "Radiation and thermal ablation should be combined. The synergy from both a theoretical and clinical standpoint is too compelling to ignore."
How RFA Works
Approved for use in the U.S. in 1997, radiofrequency ablation has also been used experimentally in the treatment of patients with liver, kidney, colon, and bone cancers who weren't good candidates for other therapies.
RFA involves the positioning of an image-guided needle within the tumor. High levels of radiofrequency energy are sent through the needle in an effort to kill tumor cells with heat while leaving surrounding tissue relatively unharmed.
It is a minimally invasive procedure, which is generally done in an outpatient setting, says Dupuy, who is director of ultrasound at Rhode Island Hospital and a professor of diagnostic imaging at Brown Medical School in Providence.
Dupuy and colleagues retrospectively examined outcomes among 41 patients with non-small-cell lung cancerlung cancer (the most common type of lung cancercancer) treated at Rhode Island Hospital over a seven-year period. All of the patients in the study had early stage tumors, but they were considered ineligible candidates for lung surgery to remove their tumors. Most had other medical conditions, such as emphysemaemphysema, making the risk of surgery too dangerous.
There are about 165,000 new lung cancers diagnosed each year in the U.S.; in about 10% of cases patients have early stage disease but are considered medically inoperable, Dupuy says.
All of the patients in the study had RFA followed by radiation, usually given within a month.
The overall survival among the patients was 87% at one year, 70% at two years, and 57% at three years. The researchers compared these findings with those from a 1990 study involving patients with similar characteristics treated with radiotherapy alone, in which the overall survival was 57% at one year, 36% at two years, and 21% at three years.
The study was published in the July issue of the Journal of Vascular and Interventional Radiology.