Patrick Sewell MD, PRESENTER: Nothing to Disclose

Abstract: Abstract #800057 aperr savage 2 8 2003-11-14T16:05:00Z 2003-11-14T16:05:00Z 1 309 1763 Computer Services 14 3 2165 9.3821 6 pt 2 2   Purpose: To determine survival following radiofrequency ablation (RFA) therapy in patients with histologically-proven nonsmall cell lung cancer (NSCLC). Materials and Methods: Under an IBR approved protocol, RFA was performed in patients with NSCLC tumors who were determined by their cardiovascular surgeon to be inoperable or who refused surgery and/or had failed chemotherapy and/or radiation therapy. The RFA was performed with a multiple time electrode (Boston Scientific Corporation, Natick, MA) advanced under CT-guidance. The RFA was performed under either conscious sedation or general endotracheal anesthesia. Patient monitoring consisted of clinical as well as radiographic studies (CT) at 1, 3, and 6 months after RFA, and then every 6 months until death. Results: A total of 45 patients with 60 tumors were treated with RFA over 3.5 years, with 13 patients classified as either Stage I or II. Tumor diameters ranged from 9mm to 102 mm. Factors associated with a prolonged treatment session or multiple treatment sessions in Stage III and IV patients were large tumor diameter, contact, or invasion of the chest wall, parietal pleura, or mediastinal structure, continuity with a large heat sink such as the great vessels, and the presence of a moderate or large pleural effusion. Despite having performed RFA in a fragile patient population, major complications were limited to COPD exacerbation (4), significant bleeding (1), pneumonia (1), and broncho-pleural fistula (1). Pneumothorax occurred in 22% of patients, with two of those presenting on days two and six post-RFA. Of the 13 Stage I and II patients, 5 (38%) had died at up to 49 months following RFA, but only 2 of the 5 died due to disease progression. Based upon a Kaplan-Meier method life table analysis, the chance of survival of the 13 Stage I and II patients post-RFA was within the range of published data from curative resection treatments for Stage I and II. Conclusion: Survival following CT-guided RFA of NSCLC appears to be on par with surgical resection for Stage I and II lesions and may be an option for respectable lesions in inoperable patients.

Sewell MD, P, Hot Topic: Patient Survival following Image-guided Radiofrequency of Primary Lung Tumors.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3800057.html