Researchers involved in a multicenter international trial have reported that the use of radiofrequency ablation for the treatment of lung cancer or pulmonary metastases provides an effective and safe therapeutic option for selected patients. These results were recently published in the July 7, 2008 issue of Lancet Oncology.

Treatment for primary lung cancer or lung metastases often consists of the surgical removal of the cancer, radiation therapy, targeted therapy, chemotherapy, and hormone therapy. The type of therapy used is largely dependent upon the individual patient and characteristics of the disease. Because some treatments are often not well-tolerated, researchers continue to evaluate ways to improve outcomes for patients with either primary or metastatic lung tumors.

Radiofrequency ablation (RFA) is commonly used for the treatment of tumors in the liver that are not amenable to surgery. The procedure involves the use of a small probe that is inserted into the site of cancer. The physician guides the probe through scans so that the treatment can be contained to the site of cancer, limiting the effect on surrounding tissue. Radio waves flow through the probe to the site of cancer, thereby destroying the cells. RFA typically requires local anesthesia, no surgery, and affects only the site of cancer without causing side effects to the rest of the body. RFA is currently being evaluated in lung tumors as well as other tumors affecting different parts of the body.

Researchers from Europe, the United States, and Australia recently conducted a clinical trial, referred to as the RAPTURE study, to further evaluate the use of RFA in lung tumors among 106 patients. Patients had either non–small cell lung cancer (NSCLC) or lung metastases, with the site of cancer within the lung measuring 3.5 centimeters in diameter or smaller. All patients were considered unsuitable for treatment with chemotherapy or radiation therapy. Patients underwent RFA and were followed for two years.

• Completion of therapy was achieved in 99% of patients; correct placement of the probe was not achievable in one small tumor.
• There were no treatment-related deaths.
• Eighty-eight percent of patients achieved a complete disappearance of cancer at the site of RFA lasting for at least one year.
• Overall survival at one year was 70%, 89%, and 92%, respectively for patients with NSCLC, patients with lung metastases from colorectal cancer, and those with metastases from other sites.
• Overall survival at two years was 48%, 66%, and 64%, respectively, for patients with NSCLC, those with lung metastases from colorectal cancer, and those with metastases from other sites.
• Only 8% of patients diagnosed with Stage I NSCLC died from their cancer at two years.

The researchers concluded that RFA appears to be a promising therapeutic approach for patients with either primary or metastatic lung cancers who are not suitable candidates for other treatment alternatives. The authors stated: “Randomised controlled trials comparing radiofrequency ablation with standard non-surgical treatment options are warranted.”

Comments: These are impressive data clearly showing that RFA is effective palliation for many patients with smaller pulmonary cancers.

Related News:

Radiofrequency Ablation and Radiotherapy Combined for Treatment of Medically Inoperable Stage I NSCLC (03/16/2006)

Radiofrequency Ablation Reported as Local Therapy for NSCLC (07/08/2005)

Radiofrequency Ablation Effective for Inoperable Lung Cancer and Lung Metastasis (04/11/2005)

Radiofrequency Ablation Shows Promise for Patients with Unresectable Lung Cancer (11/30/2004)

Reference: Lencioni R, Crocetti L, Cioni R, et al. Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE Study). Lancet Oncology. 2008; 9:621-628.