State of The Art in Alternative Treatments for Lung Cancer: Thermal Ablation Therapy (original) (raw)

Surgery is considered the best choice for stage I non-small cell lung cancer therapy and for selected patients with lung metastasis. However, surgery is often a high-risk procedure because of severe medical co-morbidities affecting this cohort of patients. Thermal Ablation (TA) has been recently proposed to achieve destruction of lung tumors whilst avoiding the use of general anesthesia and parenchyma resection, thereby limiting the invasiveness of the procedure. Two technique of TA based on tissue heating have been described: Radio Frequency Ablation (RFA) and Microwave Ablation (MWA). Both are mini-invasive procedures, delivering energy to the tumor through single or multiple percutaneous needles introduced under guidance of computed tomography. The procedure may be performed under conscious sedation or general anesthesia to avoid pain caused by needle insertion and tissue heating. We have reviewed the literature and International License, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited. reported our experience with the aim to understand whether these techniques are successful and should be proposed. In summary, we found that local efficacy is directly correlated to tumor target size: concerning RFA, tumors smaller than 2 cm can be completed ablated in 78-96% of cases; concerning MWA, according to the largest available study, 95% of initial ablations are reported to be successful for tumors smaller than 5 cm. Very few series provide survival data beyond 3 years. For nodules smaller than 3 cm, the registered survival rate is higher: 50% at five years. Data collected in the last 10 years allow to conclude that TA is an established alternative treatment for patients whose cannot undergo surgery because of compromised general condition. In the case of pulmonary metastasis, most authors agree to offer TA only if lesions are smaller than 5 cm.