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

Amanda Wallace, Presenter: Nothing to Disclose

Jonathan G. Goldin, Abstract Co-Author: Nothing to Disclose

To evaluate short and long term results at one year of CT-guided percutaneous radiofrequency ablation(RFA) in the treatment of unresectable primary non-small cell lung carcinoma (NSCLC).

From October 1, 2000, sixteen patients (9 males and 7 females; average age 64.2 years) with 22 biopsy-proven, unresectable (comorbid cardiopulmonary disease, refractory to conventional chemotherapy and/or radiotherapy, and local recurrence, etc.) non-small cell lung carcinoma were treated with RFA. Pre-RFA lung function ranged from 15%-98% FEV1. Stage of disease at RFA were as follows: 1A (4/16), 1B (4/16), 2B (1/16), 3B/4 (1/16), and 6/16 were treated following failure of conventional treatment (6/16). Three patients received neoadjuvant chemotherapy or chemotherapy prior to RFA, and six patients received adjuvant or salvage chemotherapy following RFA. Each patient was followed up for one year with serial CT scans at 1, 4, 6 and 12 months. Histopathology cell types included adenocarcinoma (18/22), bronchioalveolar (2/22), poorly differentiated (1/22) and NSCLC with neuroendocrine features (1/22).

Initial technical success was achieved in all sites (22/22) in all patients. Short term complications included pneumothorax (11/22 of which only 4/11 required catheter placement), symptomatic pleural effusion (1/22), prolonged pain (2/16 patients), dyspnea (2/16 patients), and significant contrast reaction (1/16 patients at 3 month followup CT scan). Long term outcomes revealed progressive disease (8/16 patients) and death (3/16) at 2, 7 and 8 months post-RFA, none of which directly related to the procedure. Sites of progressive disease included 2 at the RFA site, 1 within the same lobe outside RFA site, 1 malignant pleural effusion and 4 metastatic sites, including 1 with locoregional lymph node involvement.

Although technically feasible and safe, RFA as a sole treatment modality for cure for NSCLC remains questionable. No clear relationship exists between stage of disease at RFA and disease post-RFA. However, clinical trials with further focus on radiographic staging, patient selection, the role of adjuvant therapies and methods for post-RFA follow-up need to be undertaken.

R.D.S.,A.W.,J.G.G.: None

Suh, R, Wallace, A, Goldin, J, CT-guided Radiofrequency Ablation for Unresectable NSCLC: Short and Long-term Results at One Year.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4416591.html