استخدام التردد الحراري الموجه بالتصوير الطبي من خلال الجلد لإبادة الأورام السرطانية بالرئة"Image Guided RadPercutaneous iofrequency Ablation of Lung Tumors"

"Image Guided Percutaneous Radiofrequency Ablation of Lung Tumors

" Lung cancer is one of the most common malignancies in the world and continues to show an increasing incidence, and most patients with primary and secondary lung malignancies are not surgical candidates. This may be due to that many lung cancer patients have poor cardiopulmonary status or poor general health, or they are elderly and therefore considered to be at high surgical risk and are frequently referred for radiation therapy or palliative treatment.

             Over the past two decades, many ablative therapies have been studied as minimally invasive alternatives to surgery. Possible advantages of ablative therapies over surgical resection are their anticipated reduced morbidity and mortality, low cost and capability of being performed on an out patient basis.

              Radio frequency ablation works through the deposition of energy into tissue via a percutaneously placed electrode under image guidance. The energy from the electrical current in the frequency of radio waves omitted by the electrode creates heat in the local tissue, and thus, necrosis, in a controlled fashion.

     Our study included 3 groups of patients with lung malignancies that were treated with RF ablation:

- Group I : included 11 patients who had tumours  of  3 cm in diameter or less.

- Group II : included 6 patients who had tumours ranging between 3-5 cm in diameter.

- Group III:  included 4 patients who had tumours larger than 5 cm in diameter.

     The assessment of the local therapeutic efficacy of the radiofrequency ablations was done using CT-scan chest 3 months after the ablations.

              The assessment of the efficacy of treatment was based on the size of the ablated tumour, whether it regressed in size, remained stationary or increased in size.

             We divided the effect of the radiofrequency ablation on the tumors into :

-Good response : when the tumour size regressed on the follow up CT scans or remained stationary.

-Bad response : when the tumour size increased on the follow up CT scans.

      The tumor response to radiofrequency ablation of our patients’ groups were as follows:

-In group I patients: we had an overall good response of 91%.

-In group II patients: we had an overall good response of 100%.

- In group III patients: we had an overall good response of 0%.

     We had an overall complications percentage of  69%, all were minor complications, none major or life threatening. The most frequent complication encountered was pneumothorax, others were fever, pain, pleural effusions and mild hemoptysis.

      In conclusion, image guided lung RF ablation appears to be a promising technique for the treatment of NSCLC or metastatic lung disease . It is a safe and relatively straightforward minimally invasive procedure for the treatment of lung cancers. We believe that  RF therapy can potentially be used as an adjuvant therapy to classical  anticancer treatment  including chemotherapy  and radiation therapy, and might  finally prove to be  an  alternative to surgical treatment in patients with tumors smaller than 5.0 cm in diameter."