Damian Dupuy MD says “Only one-third of patients diagnosed with
non-small cell lung cancer are eligible for surgery – the rest face the
reality of having less than 12 months to live. These new outpatient
treatments not only are effective, but allow us to treat patients who
historically have no other options. Utilizing imaging and targeted
thermal ablation, we can heat and destroy lung tumors, and extend a
patients life. As a physician, it’s so gratifying to be able to provide
a treatment that is so beneficial to patients and so easy for them to
undergo.” Dupuy is the study author and a doctor at the Rhode Island
Hospital.
In this study, the two types of thermal ablation used were
radiofrequency and microwave. The thermal ablation involves heat. The
microwave ablation utilizes electromagnetic microwaves to agitate the
water molecules in the tumor and surrounding tissue. The agitation
causes the heat.
All of the patients in the study were terminal, with a life expectancy
of one year or less. Twenty-seven of the patients who underwent thermal
ablation subsequently received external-beam radiation, the primary
treatment in patients who are considered poor operative candidates.
Fourteen patients underwent thermal ablation followed by interstitial
brachytherapy, which is radiation therapy given internally to the tumor
with a catheter. Of the 41 patients, 97.6% survived to six months, 86.8%
to one year, 70.4% to two years and 57.1% to three years. The median
follow-up was 19.5 months with an average survival of 42.2 months. The
patients with tumors smaller than 3 cm (n=17) had the best outcomes,
with an average survival of 44.4 months.
There are some benefits to this procedure, according to the
researchers. It is minimally invasive and much easier on the patent
than systemic therapies. This can be performed on an outpatient basis,
and patients can begin normal activities within a few days. The authors
say that “In a small number of cases, RFA can extend patients’ lives,
but it is generally palliative.” Palliative means either pain-killing
or soothing.
The research appears in the July issue of the Journal of Vascular and
Interventional Radiology (JVIR). More information can be found at
http://www.SIRweb.org.
Dan Wilson
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