Percutaneous radiofrequency ablation for primary or secondary lung cancers

Both primary and metastatic lung cancer are common, and the prognosis for most patients is poor.

Treatment depends mainly on tumour histology and stage, and may include surgical resection (open or thoracoscopic), external beam radiotherapy, chemotherapy or a combination of these treatments. If the tumour protrudes into major airways, bronchoscopic treatments including diathermy, laser therapy, cryotherapy, brachytherapy and photodynamic therapy may be used.

Percutaneous radiofrequency ablation (RFA) may be used in patients with small, early-stage lung cancers or small numbers of lung metastases who are unsuitable for, or prefer not to undergo, surgery. It may also have a place in multi-modality treatment of more advanced primary lung cancers.

The procedure is usually carried out with the patient under local anaesthesia with conscious sedation, but general anaesthesia may be required. The procedure involves inserting a small needle electrode percutaneously directly into the tumour, normally under CT guidance. Radiofrequency energy is passed through the electrode causing heating of the tissues around the tip of the needle. The tumour tissue in the target area is coagulated. A small margin of normal tissue around the tumour is also destroyed to reduce local recurrence risk.

The procedure can be applied to more than one tumour during one or more treatment sessions, and can be used alone or in combination with surgery, radiotherapy or chemotherapy.