The use of radiofrequency ablation for the treatment of lung cancer and lung metastases from breast, colon, and prostate cancers and melanoma is effective and safe for some patients. These results were recently published in the Lancet Oncology.
Lung cancer is responsible for more cancer-related deaths than the next three most deadly cancers combined. If cancer originates in the lung, it is referred to as primary lung cancer. 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.
Lung metastasis refers to cancer that has spread to the lung from other sites in the body. Lung metastases are common among patients diagnosed with advanced breast, colon, and prostate cancers as well as melanoma and other solid tumors.
Treatment for primary lung cancer and lung metastases often consists of the surgical removal of the cancer, radiation therapy, targeted therapy, chemotherapy, and hormone therapy. The type of therapy used depends largely upon the individual patient and characteristics of the disease. Because treatment is 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 inserted into the site of cancer. The physician guides the probe through scans so that the treatment can be contained within the site of cancer, limiting the impact 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 NSCLC or lung metastases, with the site of cancer within the lung measuring 3.5 centimeters in diameter or smaller. All patients were considered ineligible 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
- 88% of patients achieved a complete disappearance of cancer at the site of RFA, which lasted 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 (stage at which the cancer has not spread outside the lung) died from their cancer at two years.
The researchers concluded that RFA appears to be a promising treatment 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.”
Patients with lung tumors who are not candidates for standard therapeutic approaches may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating RFA or other standard therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.eCancerTrials.com.
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.
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