CT Guided Radiofrequency Ablation Followed Intratumoral Chemotherapy 
in the Treatment of Early Stage Non-small Cell Lung Cancer

Abstract

Background and objective Radiofrequency ablation (RFA) has become one of the local treatment for inoperable early stage non-small cell lung cancer (NSCLC). This study observes effectiveness and safety of computed tomography (CT) guided RFA followed intratumoral chemotherapy (RFA-ITC). Methods From 2005 to 2015, our group perspectively enrolled inoperable early stage NSCLC underwent RFA-ITC duo to poor cardiopulmonary function or with other diseases or patient can't tolerate or reject surgery. RFA was performed by a directive apparatus assisted CT guided semi real-time and step-by-step puncture method, conformal umbrella-shaped electrode and single or multiple targets ablation. While the plan finished and CT showed normal lung tissue around the tumor present ground-glass opacity (GGO), the procedure ended, then 200 mg of carboplatinum were injected into the tumor via the electrode needle. Safety and effectiveness were evaluated by follow-up. Results Technical success rates of 125 RFA-ITC treatments of 110 patients were 100%. The median survival was 48.0 months, overall survival (OS) was 55.4 months, progression-free survival was 55.1 months, 1, 2, 3, 5-year OS rates were 100%, 90.7%, 62.7%, 21.9%, respectively. Survival of GGO presence or not was 68.3 months and 40.1 months, respectively (P=0.001). The survival rates of the N1 staging and tumor size was no significant difference. No perioperative deaths occurred, the main complications i.e. pneumothorax, pulmonary hemorrhage, pleural effusion, fever, intraoperative chest pain, subcutaneous emphysema, intraoperative cough were slight and tolerable. Conclusion CT guided RFA-ITC provides a good method for treatment of inoperable early stage NSCLC with better survival, less complication and small damage.

Keywords

• Lung neoplasms
• Radiofrequency ablation
• Intratumor chemotherapy