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The Role of Radiofrequency Ablation in the Treatment of Stage 1 Non-Small Cell Lung Cancer

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Advances in Radiation Oncology in Lung Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

Currently, the standard of care for stage I non-small cell lung cancer (NSCLC) is surgical resection. Although this treatment modality has been demonstrated to have 5 year survival rates approaching 80%, there need to be effective alternative treatments for patients who are medically inoperable. Radiofrequency ablation (RFA) has emerged as a minimally-invasive therapy to fill this void. This modality has been found to be most effective for treatment of small (<3 cm), peripheral lesions that are located distal to vasculature, large airways, and the mediastinum. The most common complications after RFA include pneumothorax, pneumonia, and pleural effusion. To date, accurate assessment of the efficacy of RFA has been difficult to determine due to short follow-up times of current studies and the lack of standard definitions of local recurrence as well as toxicity. Current literature has suggested local progression rates ranging from 20 to 42%, but assessment by prospective trials with long-term follow-up and standardized definitions of toxicity and local control are needed to determine the true benefit of this procedure.

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Abbreviations

AICD:

Automatic implantable cardioverter defibrillator

AZ:

Ablation zone

C:

Centigrade

CA:

Complete ablation

CN:

Complete necrosis

CR:

Complete response

CSS:

Cancer specific survival

CTCAE:

Common terminology criteria for adverse events

DFS:

Disease-free survival

DR:

Distal recurrence

EBUS:

Endobronchial ultrasound

EP:

Extrapulmonary recurrence

F/U:

Follow-up

GGA:

Ground-glass attenuation

H&E:

Hematoxylin and eosin staining

H&M nodes:

Hilar and mediastinal nodes

IA:

Incomplete ablation

IP:

Intrapulmonary recurrence

LC:

Local control

LR:

Local recurrence

MAM:

Monoclonal anti-mitochondrial antibodies

Mn:

Months

NS:

Not stated

NSCLC:

Non-small cell lung cancer

PFS:

Progression-free survival

PNB:

Percutaneous biopsy

Pneumo:

Pneumothorax

R:

Recurrence

RECIST:

Response evaluation criteria in solid tumors

RF:

Radiofrequency

RFA:

Radiofrequency ablation

RT:

External beam radiotherapy

RT-br:

Brachytherapy

RTOG:

Radiation therapy oncology group

S:

Survival

SBRT:

Stereotactic body radiation therapy

SVB:

Supravital blue staining

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Authors and Affiliations

  1. Radiation Oncology—CH63, Penn State Hershey Cancer Institute, 500 University Drive, PO Box 850, Hershey, PA, 17033, USA

    John M. Varlotto & Julia A. Shelkey

  2. Department of Radiology, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA , 17033, USA

    Rickhesvar P. Mahraj

Authors
  1. John M. Varlotto
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  2. Julia A. Shelkey
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  3. Rickhesvar P. Mahraj
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Corresponding author

Correspondence to John M. Varlotto .

Editor information

Editors and Affiliations

  1. Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, 21204, Serbia

    Branislav Jeremic

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© 2011 Springer-Verlag Berlin Heidelberg

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Varlotto, J.M., Shelkey, J.A., Mahraj, R.P. (2011). The Role of Radiofrequency Ablation in the Treatment of Stage 1 Non-Small Cell Lung Cancer. In: Jeremic, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_230

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  • DOI: https://doi.org/10.1007/174_2011_230

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-19924-0

  • Online ISBN: 978-3-642-19925-7

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