Guided Heat for Inoperable Lung Cancer
Procedure Called RF Ablation as Effective as Radiation for Some Patients, Study Reports
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.
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
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%,
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
"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.