From the annual meeting of the Society of Interventional Radiology (SIR) held in Washington, D.C.

WASHINGTON, D.C. | “Cooking” lung tumours with radiofrequency ablation enables patients with inoperable local disease to increase their survival by two or more years, according to a study presented at the SIR meeting here.

The finding adds to a growing body of evidence that radiofrequency ablation (RFA) extends survival time from lung cancer, a disease which otherwise has seen little change in its survival rates in the last 40 years, despite tremendous amounts of research.

“It’s clear that if you want to be cured of (lung) cancer, most patients will be cured by surgery. You can have surgery with other therapies but if you don’t go for surgery it will not be cured in most instances,” said Dr. Thierry de Baere, an interventional radiologists with the Institut Gustave Roussy in Villejuif, France.

“And what we are trying, as interventionalists, is to develop other techniques like ablation therapies that try to do the same thing as surgery.”

Critically, Dr. de Baere pointed out, lung cancer remains the leading cause of cancer death for both men and women in North America and the world, but only 20% of these patients are actually able to tolerate surgery and typically have less than one year to live.

However, in his study he found that in these inoperable patients with local—but not metastatic—disease, RFA can provide effective control of tumours with two years’ survival close to what is reported in surgical series.

Moreover, the minimally invasive procedure required less recovery time and was associated with low rates of mild to moderate pain, hemoptysis, pneumopathy and respiratory insufficiency after hospital discharge.

During RFA, a small needle is guided into the cancer, generally by computed tomography, and electrical energy transmitted to the needle’s tip produces enough heat to kill the tumour and shrink dead tissue, leaving a scar. At the same time, the RFA also closes small blood vessels, lessening the risk of bleeding.

Dr. de Baere and his colleagues reported outcomes with RFA in a series of 47 adults, ranging from 27 to 85 years, with primary non-small cell lung cancer.

Outpatient treatment with the procedure in these patients—who typically have only palliative options such as chemotherapy or radiation—resulted in survival rates of 89% in the first year and 70% in the second.

As well, 85% had no viable lung tumours after one year on imaging and 77% had none after two years, which indicates a cure.

An important distinction, however, was made regarding the size of the cancers. In the study, the rate of local tumour progression at two years for growths less than 2 cm was 8%, which was statistically significantly different than the 19% progression for tumours larger than 2 cm.