According to an article recently published in the Journal of Vascular and Interventional Radiology, the combination of RFA plus radiation therapy may improve survival compared with either modality alone in the treatment of inoperable, early lung cancer.
Lung cancer remains the leading cause of cancer-related deaths annually in the United States. More people die every year from lung cancer than from colon cancer, prostate cancer, and breast cancer combined. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer; “non–small cell” refers to the type of cell within the lung where the cancer originated.
Many patients with lung cancer are not able to undergo the surgical removal of their cancer, either due to the extent of spread, its anatomical location, and/or the patients’ overall health. Researchers continue to evaluate well-tolerated and effective treatments for these patients.
Radiofrequency ablation (RFA) is a minimally invasive technique that uses heat to destroy cancer cells. During RFA, an electrode is placed directly into the tumor; the procedure is guided by a CT scan, ultrasound, or laparoscopy. The electrode’s high frequency radio waves create intense heat, which destroys the cancer cells.
Radiofrequency ablation is being explored in the treatment of several types of cancer, including lung, kidney, and liver cancers. Previous studies of RFA have most often focused on patients who are unable to tolerate surgery or those with cancer that is considered inoperable; however, studies evaluating RFA are now including more patients with lung cancer. Microwave ablation, which is another form of thermal ablation, is sometimes used in place of RFA.
Researchers from Brown University in Rhode Island recently conducted a clinical trial to evaluate the combination of RFA plus radiation therapy for the treatment of inoperable, early NSCLC (cancer that has not spread from the lung to distant sites in the body). This trial included 41 patients who underwent RFA (four underwent microwave ablation) plus radiation therapy between 1998 and 2005.
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- At six months, survival was 98%.
- At one year, survival was 87%.
- At two years, survival was 70%.
- At three years, survival was 57%.
- Patients with cancers smaller than 3 centimeters in diameter had an average survival time of 44 months.
- Patients with large cancers had an average survival time of 35 months.
The researchers concluded that RFA or microwave ablation in addition to radiation therapy may improve survival compared to either treatment modality alone among patients with inoperable, early-stage NSCLC. Future studies to directly compare this combination to either treatment alone are required to understand its role in the clinical setting. Patients with inoperable NSCLC may wish to speak with their physician regarding their individual risks and benefits of a combination of RFA plus radiation therapy.
Reference: Grieco C, Simon C, May-Smith W, et al. Percutaneous Image-guided Thermal Ablation and Radiation Therapy: Outcomes of Combined Treatment for 41 Patients with Inoperable Stage I/II Non–Small-Cell Lung Cancer. Journal of Vascular and Interventional Radiology. 2006; 17:1117-1124.
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