Computed Tomography-Guided Radiofrequency Ablation of Malignant Lung Lesions: Early Experience

Galbis-Caravajal, José M.; Pallardó-Calatayud, Yolanda; Revert-Ventura, Antonio; Sales-Badía, Jesús G.; Esturi-Navarro, Rafael; Cuenca-Torres, María

doi:10.1016/S1579-2129(08)60063-4

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Objective

To present our early experience in the treatment of primary malignant and metastatic lung lesions by radiofrequency ablation.

Patients and methods

From August 2004 through January 2007 we treated 19 patients (in 26 procedures) with curative or palliative intent. None of the lesions was amenable to surgery and some had been treated previously. The procedure was performed in the radiology room under conscious sedationanalgesia administered by an anesthesiologist. Fourteen patients were treated for pulmonary lesions and 5 for metastatic lung disease in a context of controlled primary disease. Treatment was with curative intent in 15 cases and palliative in 4.

Results

The radiofrequency technique was applicable in 26 procedures and the mean follow-up was 8.68 months. The principal complications of radiofrequency treatment were pneumothorax in 4 patients, requiring drainage in only 2 cases; pneumonitis in 4; self-limiting pulmonary hemorrhage in 1; and pleural effusion in 5. There were no procedure-related deaths. Six patients died during the follow-up period.

Conclusions

In our experience, radiofrequency offers a safe and minimally invasive option for the treatment of malignant lung lesions in appropriately selected, nonsurgical patients. Morbidity is low, and in combination with other treatments this technique opens up a wide range of possibilities still to be explored.

Key words:

Radiofrequency ablation

Stage I lung cancer

Lung metastases

CT-guidedpuncture

Objetivo

Presentar la experiencia inicial en el tratamiento de las lesiones pulmonares malignas (primarias y metastá-sicas) mediante la ablación por radiofrecuencia (RF).

Pacientes y métodos

De agosto de 2004 a enero de 2007 tratamos a 19 pacientes (mediante 26 procedimientos) con intención curativa o paliativa. Todos los casos correspondían a lesiones no quirúrgicas, tratadas o no previamente. La técnica se practicó en la sala de radiología, con sedoanalgesia consciente Ilevada a cabo por el anestesiólogo. Se trató a 14 pacientes con lesión pulmonar y a 5 con enfermedad metástasica pulmonar, con la enfermedad primaria controlada. En 15 casos el tratamiento se realizó con intención curativa y en 4 era paliativo.

Resultados

La técnica de RF pudo realizarse en los 26 procedimientos. La media de seguimiento fue de 8,68 meses. Las principales complicaciones derivadas del tratamiento de RF fueron: neumotórax en 4 pacientes, de los que sólo 2 requirieron drenaje; neumonitis en 4; hemorragia pulmonar autolimitada en 1, y derrame pleural en 5. No hubo mortalidad en relación con el procedimiento. Durante el período de seguimiento fallecieron 6 pacientes.

Conclusiones

Según nuestra experiencia, la RF puede ser una opción segura y mínimamente invasiva para el tratamiento de las lesiones pulmonares malignas en pacientes no quirúrgicos adecuadamente seleccionados, con una baja morbilidad. La combinatión con otros tratamientos ofrece un amplio abanico de posibilidades pendientes de discernir.

Palabras clave:

Ablación por radiofrecuencia

Carcinoma pulmonar estadio I

Metástasis pulmonares

Punción dirigidapor TC

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