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A phase II study of radiofrequency ablation therapy for thoracic malignancies with evaluation by FDG-PET

Abstract

Purpose

Computed tomography (CT)-guided radiofrequency ablation (RFA) is safe and effective for patients with unresectable primary, recurrent, or metastatic thoracic malignancies. Several studies have shown the benefit of employing 18-fluoro-deoxyglucose positron-emission tomography (FDG-PET) to follow thoracic malignancies treated with RFA. In this prospective study, we show the safety and therapeutic efficacy of RFA and the utility of FDG-PET as tool for early detection of local recurrence.

Methods

Twenty patients were enrolled in this study, and 24 lesions were ablated. Seven lesions were primary lung cancer, and 17 lesions were recurrent tumors or metastases from extrathoracic sites. Tumor size was in the range of 0.4–3.3 cm in diameter (mean: 1.5 cm). CT and FDG-PET scans were scheduled 7–14 days and 3–6 months after RFA treatment.

Results

There were 17 adverse events (70.8 %) in 24 ablations included 13 pneumothoraces, two cases of chest pain, and two episodes of fever. With a median follow-up of 35.9 months (range 1–62 months), the overall 2-year survival rate was 84.2 %. Local recurrence occurred at four sites (2-year local control rate was 74.3 %). The FDG-PET results 7–14 days after RFA did not predict recurrence, whereas positive findings 3–6 months after RFA significantly correlated with local recurrence (p = 0.0016).

Conclusions

We confirmed the effectiveness of RFA for unresectable primary and secondary thoracic malignancies. FDG-PET analysis 3–6 months after ablation is a useful tool to assess local control.

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Abbreviations

CT:

Computed tomography

RFA:

Radiofrequency ablation

FDG-PET:

18-Fluoro-deoxyglucose positron-emission tomography

ppo FEV 1:

Predictive postoperative forced expiratory volume in one second

DLCO:

Carbon monoxide diffusing capacity

PaO2 :

Arterial oxygen pressure

SpO2 :

Saturated oxygen in arterial blood

SBRT:

Stereotactic body radiotherapy

IMRT:

Intensity-modulated radiation therapy

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Conflict of interest

All authors declare that they have no conflict of interest.

Author information

Correspondence to Mitsunori Higuchi.

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Higuchi, M., Honjo, H., Shigihara, T. et al. A phase II study of radiofrequency ablation therapy for thoracic malignancies with evaluation by FDG-PET. J Cancer Res Clin Oncol 140, 1957–1963 (2014). https://doi.org/10.1007/s00432-014-1743-y

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Keywords

  • Percutaneous catheter ablation
  • Positron-emission tomography lung neoplasms
  • Radiofrequency ablation