Image-Guided Radiofrequency Ablation as a New Treatment Option for Patients with Lung Cancer

e e a c a ung cancer is the leading cause of cancer deaths among men and women in the United States with a death rate of 2% in males and 25% in females, surpassing the mortality ates from colon, prostate, and breast cancer combined. In 004, an estimated 173,700 Americans will receive a diagosis of lung cancer and 160,440 will die of the disease.1 Approximately 80% of new lung cancer cases are of the on-small-cell type, with an estimated 5-year overall survival ate of 10 to 18%. At present, surgical resection remains the nly therapeutic modality with a curative potential in paients with early-stage non-small-cell lung cancer (NSCLC), hough the 5-year survival rates remain dismal even after urgical treatment, in the range of 63 to 67% in Stage IA, 46 o 57% in Stage IB, 52 to 55% in IIA, 33 to 39% in IIB, and nly 19 to 23% in Stage 111A.2,3,4 In practice only one-third of patients are eligible for surgial intervention.5 Many patients with coexistent medical orbid conditions such as poor cardiopulmonary reserve nd advanced stage of the disease are found to be unsuitable or surgery at the time of diagnosis. In these patients the reatment options rely on radiotherapy (XRT) with or withut chemotherapy. In a meta-analysis determining the effeciveness of radical XRT for Stage I/II medically inoperable SCLC patients, overall 5-year survival ranged from 0 to 2%, with complete response rates of 33 to 61% and local ailure rates ranging from 6 to 70%.6 There has been a limited ole of chemotherapy in NSCLC. A meta-analysis of trials omparing primary treatment with or without chemotherapy hows only modest benefit of chemotherapy.7 These factors have led to a search for alternative modalities hich could accomplish tumor destruction or complete radication, complementing, improving, or potentially relacing the existing modalities. Percutaneous image-guided hermal ablation with radiofrequency (RF) has recently been sed as a minimally invasive approach for a variety of solid umors including liver, kidney, breast, bone, adrenal, and