Riccardo Antonio Lencioni MD, Presenter: Nothing to Disclose

Laura Crocetti MD, Abstract Co-Author: Nothing to Disclose

Roberto Cioni, Abstract Co-Author: Nothing to Disclose

Robert Daniel Suh MD, Abstract Co-Author: Nothing to Disclose

Amanda Wallace, Abstract Co-Author: Nothing to Disclose

Carlo Bartolozzi MD, Abstract Co-Author: Nothing to Disclose

This study is designed to determine the effectiveness of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) of stage IA non-small cell lung cancer (NSCLC).

Fourteen patients (12 males and 2 females; age range, 50-74 years; mean 66 years ± 7; median, 67 years) with stage IA, biopsy-proven NSCLC were enrolled in an on-going prospective, multicenter clinical trial. Lesion longest diameter ranged 1.0-3.0 cm (mean, 2.2 cm ± 0.7). All patients were considered unfit for surgery and radical radiotherapy. CT-guided RFA was performed under conscious sedation by using a 150-W generator and expandable multi-array needles (RITA Medical Systems, Mountain View, CA). Follow-up period ranged 1-14.5 months (mean, 8.2 months ± 4.9) and included CT examinations performed 1 and 3 months after the procedure and at 3-month intervals thereafter.

RFA was technically feasible in all 14 patients. CT obtained 1 month after RFA showed a round, ground-glass density area encompassing the treated lesion in all cases. Nine (82%) of 11 patients who were followed up for at least 6 months after RFA showed progressive shrinkage of the treated lesions on CT scans, with no signs of local recurrence. Complete ablation of treated lesions was confirmed by the absence of tumor re-growth over a follow-up period of 1 year or more in 7 patients. Major complications consisted of pneumothorax (n=3) and pleural effusion (n=1) requiring treatment. Pulmonary function tests and quality of life questionnaires did not show any significant decline with respect to baseline. At the time of the analysis, 12 patients were alive, and 2 patients were dead. Preliminary survival analysis by the Kaplan-Meier method showed a 1-year overall survival rate of 81%, and 1-year cause-specific survival rate of 100%.

Percutaneous RFA yields high local tumor control rates in patients with stage IA NSCLC, and is associated with acceptable morbidity. RFA might prove a viable alternate treatment method for stage IA NSCLC in patients without surgical prospects.

R.A.L.,L.C.,R.D.S.,C.B.,R.C.,A.W.: The study was supported in part by a research grant from RITA Medical Systems, Mountain View, CA.

Lencioni, R, Crocetti, L, Cioni, R, Suh, R, Wallace, A, Bartolozzi, C, Percutaneous Radiofrequency Ablation of Stage IA Non-small Cell Lung cancer: A Prospective Multicenter Clinical Trial.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4408997.html