Key result
Combination therapy with segmental pulmonary arterial chemoembolization and radiofrequency ablation achieved a complete response in 65% of patients with unresectable lung tumors at 6 months.
Why the study?
Does combination therapy with segmental pulmonary arterial chemoembolization and radiofrequency ablation improve local tumor progression in patients with unresectable lung malignancy?
Does combination therapy with segmental pulmonary arterial chemoembolization and radiofrequency ablation improve local tumor progression in patients with unresectable lung malignancy?
Combination therapy with SPACE and RF ablation is technically feasible, safe, and effective for unresectable lung tumors, with high complete response rates.
Answers are grounded in this paper and cite their sources.
May support evaluation in unresectable lung tumors; hypothesis-generating and requires randomized confirmation.
PURPOSE: To evaluate the feasibility, safety, and effectiveness of combining segmental pulmonary arterial chemoembolization (SPACE) and percutaneous radiofrequency (RF) ablation in patients with unresectable lung neoplasms or patients with resectable neoplasms who refused surgery and to compare the local tumor progression (LTP) rate with that in previous studies of RF ablation alone. MATERIALS AND METHODS: After institutional review board approval and informed consent, 17 patients with primary and metastatic lung cancer were enrolled in this prospective study. Between January 2008 and February 2011, 20 nodules (median diameter, 3.0 cm; range, 2.0-5.0 cm) were treated during 19 sessions. Antineoplastic agents loaded on 50-100-µm microspheres were selectively infused into specific pulmonary arteries. Percutaneous computed tomography (CT)-guided RF ablation of lung nodules was performed 48 hours after SPACE. Follow-up consisted of enhanced CT 48 hours after combination treatment was completed, after 30 days, and every 3 months thereafter. Fluorine 18 fluorodeoxyglucose positron emission tomography was performed 3 months after combination therapy and then every 6 months. The t test was used to compare groups. RESULTS: Technical success was achieved in 100% of cases. Ventilation-lung single photon emission computed tomography showed a wide area without ventilation in the lung parenchyma treated with SPACE. The LTP rate was 21% (three of 14 nodules) in 3-5-cm-diameter tumors and 0% (zero of six nodules) in tumors of 3 cm or smaller in diameter. Complete response was achieved in 65% (11 of 17) of patients at minimum follow-up of 6 months. Overall, treatment was well tolerated. Major complications were pneumothorax in five of 19 sessions (26%) and one bronchopleural fistula (one of 19, 5%). No treatment-related changes in general lung function were noted. CONCLUSION: Combination therapy with RF ablation after SPACE to treat unresectable lung tumors is technically feasible, safe, and effective and may represent an advantage over RF ablation alone.
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Gadaleta et al. (2012) studied Primary and metastatic lung cancer (n=17). Segmental pulmonary arterial chemoembolization (SPACE) and percutaneous radiofrequency (RF) ablation was evaluated on Complete response. Combination therapy with segmental pulmonary arterial chemoembolization and radiofrequency ablation achieved a complete response in 65% of patients with unresectable lung tumors at 6 months.
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