RADIOFREQUENCY THERMAL ABLATION OF 39 LUNG NEOPLASMS-A PHASE I-II STUDY
Gadaleta CD,Catino A, Colucci G, Cramarossa A, Mattioli V, Lorusso V, Cannello E, Timurian A, Ranieri G, Fiorentini G and De Lena M
I.R.C.C.S. Oncologico Bari-Italy
Radiofrequency thermal ablation (RFA) is a minimally invasive treatment most commonly used for liver tumors. Recently, this promising technique has been tested in the therapy of various neoplasms, such as kidney, prostate, breast and lung tumors. From February 2002 to February 2003, we performed radiofrequency ablation of lung neoplasms in 17 patients (13 patients with lung metastases from different solid tumors, and 4 patients with primary unresectable NSCLC). Median age was 69 years (range 26-81). A total of 39 lesions was treated, with median diameter of 3 centimeters (range 1-11 cm.). All patients were previously treated with systemic chemotherapy.. RFA was performed percutaneously using a cooled-tip electrode-needle (Radionics, Burlington, MA) under general anesthesia and guided with ultrasound and /or computed tomography (CT) scan. Prophylactic antibiotherapy with parenteral cephalosporin was administered to all patients. No major complication occurred; 7 patients showed early post-treatment minimal pleural effusion, resolved spontaneously within 24-48 hours. In 3 cases pneumothorax occurred, and patients were submitted to pleural drainage; moderate and short-lasting fever was observed in 10 patients, easily controlled by antipyretics. Most of patients were discharged from the hospital within 7 days. Helical CT scan was performed in all cases before treatment and 30 days after RFA, showing the treated lesion as a hypodense area, with partial excavation without enhancement, circumscribed by an hyperdense ring.These preliminary data show that radiofrequency ablation is a safe and feasible procedure to destroy lung tumors; despite the small number of cases and the short follow up of this ongoing study, further investigation is suggested to define the potential role of this technique in a multidisciplinary approach of primary and secondary lung neoplasms.