Percutaneous radiofrequency ablation in the treatment of pulmonary malignancies: efficacy, safety and predictive factors

Purpose: The purpose of this study was to evaluate the efficacy, safety and predictive factors of RFA of primary and secondary lung malignancies.

Patients and methods: 79 patients with 129 primary and secondary lung malignancies were enrolled in a retrospective study. We treated 74 pulmonary metastases of colorectal cancer, 13 malignant melanoma lesions, 13 renal cancer metastases, 5 primary lung malignancies and 24 tumors of other different entities. All patients were considered to be unsuitable candidates for surgery, radiotherapy or chemotherapy. The primary endpoint was local tumor control, secondary endpoints were overall survival, safety and predictive factors, e.g. distance to pleura, vessels and bronchi.

Results: The median tumor size was 1.2 cm (0.5-3.0 cm). After a median follow-up of 14 months (3-81 months), the LTC was 85.3 %. There were 34 lesions (26.4%) with complete remission, 48 (37.2 %) partial remission, 28 (21.7%) stable disease and 19 lesions (14.7%) with progressive disease. We evaluated an OS of 27 months. Pneumothorax in 19 cases (14.7%) and pleural effusion in 2 cases (1.6 %) were the leading complications (CTCAE, 5 grade III adverse events). The only significant influence regarding the outcome after RFA was the initial tumor size (p = 0.01). Distance to vessel, bronchi, and pleura showed no significant effect (p = 0.81; p = 0.82; p = 0.80).