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In one study conducted in France, patients with advanced lung cancer who were not candidates for surgery underwent a procedure known as radiofrequency ablation (RFA), which basically heats the tumours and kills them.
Seventy percent of the patients with lung metastases or primary non-small cell lung cancer were still alive after two years - similar to results seen after surgery.
Furthermore, 85 percent of patients with non-small cell primary lung cancer treated with RFA had no viable tumours visible on imaging one year later, while 77 percent had no viable tumours after two years.
What the findings mean
"It means that you can actually do a very good job of local control of lung tumours in patients who aren't fit for surgery," said Dr Damian Dupuy, a professor of diagnostic imaging at Warren Alpert Medical School at Brown University and director of tumour ablation at Rhode Island Hospital in Providence.
"The medical establishment, being very conservative, has always said if you aren't fit for surgery you just basically get chemo and radiation and most of the time they don't work well and you die of your tumour. But even the most unfit for surgery can have this procedure safely," Dupuy said.
The Brown researcher was not involved in the French study, but his group completed a lung cancer trial last year with similarly good results.
The new study, led by Dr Thierry de Baere of Institute Gustave Roussy, in Villejuif, France, was to be presented at the annual meeting of the Society for Interventional Radiology in Washington, D.C.
Procedure holds promise
Lung cancer is the number one cancer killer in the United States and a full 25 percent of patients who have operable disease can't undergo surgery because of co-existing conditions, Dupuy noted.
"This is a huge advance for them," he said. "This procedure is done at almost every hospital that has an interventional radiologist, which is most. It's like a lung biopsy."
"If you have to stick a needle in to diagnose lung cancer anyway, why not do it in a single sitting?" Dupuy asked.
Most patients go home the same day, he noted. According to Dupuy, the procedure may also hold promise for pain relief in patients who are dying.
Two other studies focus on freezing tumours
Two other studies presented at the meeting used the other end of the temperature spectrum - cryoablation - to successfully freeze and kill kidney cancer tumours.
"This is a minimally invasive, non-surgical cancer treatment without an incision, explained Dr Christos S. Georgiades, lead author of one of the studies and an assistant professor of radiology and surgery at Johns Hopkins Hospital in Baltimore.
"You put a probe, which is basically a needle, into the tumour, freeze the central volume of the tissue with temperatures close to negative 150 degrees centigrade. The patients don't feel the cold."
In Georgiades' study, the procedure was 95 percent effective for tumours four centimetres or smaller and almost 90 percent effective in tumours up to seven centimetres in diameter after one year. This was in patients with disease that had not yet spread beyond the kidney, he noted.
'Proving it works'
"The technique has been around for a few years, but we're only now proving that it works," Georgiades said. "Patients have recovery close to that of surgery and many do not have to have surgery. Many procedures are done on an outpatient basis."
The third study, from the Barbara Ann Karmanos Cancer Institute in Detroit, looked at tumours treated with cryoablation whose average size was 2.8 centimetres. After 1.3 years, most of the tumours still came up on imaging as dead tissue, the team found. – (HealthDay News)
March 2008
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