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Guided Heat for Inoperable Lung Cancer

Procedure Called RF Ablation as Effective as Radiation for Some Patients, Study Reports
By
WebMD Health News
Reviewed by Louise Chang, MD

doctor and patient

March 27, 2007 -- A minimally invasive treatment that uses guided heat to kill cancer cells shows promise as an alternative to radiation in patients with inoperable, early-stage lung cancers.

Researchers say radiofrequency (RF) ablation may offer older, sicker patients who are not good candidates for surgery an easier-to-tolerate treatment than radiation.

That's their conclusion after a study looking at 153 lung cancer patients with inoperable disease who were treated with RF ablation.

Of those with stage I disease, or early-stage cancer confined to the lung, 57% lived for at least two years following the treatment. Three-year survival was 36% in the patients, who generally had other serious health problems such as emphysema or heart disease.

“We showed that RF ablation can result in decent outcomes even in this very frail and sick population,” Damian E. Dupuy, MD, tells WebMD.

Single-Day Treatment

RF ablation has been used in the United States for a decade, most often for the treatment of patients with liver, kidney, colon, and bone cancers who are not good candidates for other treatments.

The procedure involves positioning an image-guided needle within the tumor to transmit mild, painless radiofrequency energy similar to microwave heat. The aim is to kill tumor cells with heat while leaving surrounding tissue relatively unharmed.

RF ablation is generally performed in a single day in an outpatient setting. Conventional external beam radiation (EBT) involves as many as 33 treatments delivered over six weeks.

"It is important for physicians to know that RF ablation is a treatment option for their sickest and elderly patients," Dupuy says.

In the newly reported study, published in the April issue of Radiology, Dupuy and colleagues used RF ablation to treat 116 patients with primary lung cancers and 73 patients whose primary cancers had spread to a lung.

The one, two, three, four, and five-year survival rates for patients with stage I, non-small-cell lung cancers were 78%, 57%, 36%, 27%, and 27%, respectively.

Survival Advantage?

The researchers say their outcomes compared favorably with those reported in other studies of patients treated with radiation and may even show a survival advantage for RF ablation.

Jerome W. Yates, MD, of the American Cancer Society, tells WebMD that no localized therapy, be it radiation or RF ablation, is likely to have a dramatic impact on lung cancer survival rates.

"The problem with lung cancer is that it has usually spread by the time we make a diagnosis, so localized treatments are not very effective in terms of curing disease," he says. "These seem to be comparable therapies in terms of outcome."

Yates, who is the ACS’s national vice president for research, agrees that RF ablation offers what could be an easier-to-tolerate treatment option for early-stage lung cancer patients with inoperable disease.

But he adds that significant improvements in lung cancer survival will come only with better ways of treating the disease once it has spread beyond the lungs, or better technologies to detect the disease before it has spread.

Dupuy says targeted therapies like RF ablation will become even more important treatments for early-stage lung cancer as such diagnostic advances occur.

"In my lifetime, with improvements in lung cancer imaging and screening, I foresee techniques like radiofrequency ablation effectively treating very small lung cancers and saving patients from surgery," Dupuy says.

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