RFA effective for easing lung cancer symptoms; CT findings identified that verify successful RFA

CT-guided radiofrequency ablation (RFA) is effective in easing the symptoms of lung tumors that cannot be removed by surgery, and enhancement pattern and changes in the size of the tumor as shown on CT are the most important factors for determining whether that ablation has been successful, according to a pair of independent studies in the October 2004 issue of the American Journal of Roentgenology.

For the first study, researchers from Caserta’s S. Sebastiano Hospital in Italy analyzed 33 patients with malignant lung cancer who could not undergo surgery and opted for CT-guided RFA instead. No major complications occurred for any patient during RFA, and all RFA sessions were deemed successful at follow-up CT.

According to Giuseppe Belfiore, MD, lead author of the article, the study was prompted by the feeling that an alternative to the usual therapies for lung cancer was strongly needed. “We see too many lung cancer patients who, inoperable for a number of different reasons, are left with few chances to obtain an effective palliation,” said Dr. Belfiore. “We believe that a powerful alternative/complementary option is now available, although we believe that the full potential of RFA is still to be assessed. For sure, RFA allows a better quality of life for many inoperable patients,” Dr. Belfiore added.

In a separate but related study, researchers from Chonbuk National University Hospital in South Korea determined that pattern enhancement–a difference in contrast between a tumor and the surrounding tissue–and changes in tumor size were the most important factors in judging the success of RFA for lung tumors on CT.

The researchers analyzed 21 patients who had undergone CT-guided RFA for lung tumors, nine of whom had complete ablations and 12 of whom had partial ablations performed. For the former group, the researchers found that the tumors were without any enhancement on short-term follow-up CT and that the size of the lesions had decreased by 40% after 12 months. For the partially ablated group, the tumors were enhanced to various degrees at short-term and the tumor size had increased after six months.

“During the past two years there have been increasing reports of RFA being performed for lung tumors, but, to our knowledge, no study has focused on the changes of ablated lung tumors on follow-up CT. Based on our results, we conclude that an enhancement pattern is a reliable finding for assessing the precise therapeutic efficacy of RFA on immediate follow-up CT. In addition, the knowledge of the size changes of the ablated tumors on long-term follow-up CT is helpful in assessing a tumor’s response to RFA in lung cancer,” said Jeong Min Lee, MD, one of the authors of the study.