Image-guided percutaneous microwave thermal ablation (MWA) appears to be safe and effective for the treating primary lung malignancy with outcomes that may be comparable to stereotactic body radiation therapy (SBRT), according to study published in Clinical Radiology. Researchers reported that ablation of pulmonary malignant tumors may be a safe treatment option in select patients. However, they caution that their findings are limited due to the retrospective nature of their study and a relatively short follow-up, small sample size, and heterogeneity in diagnosis.1
Tsakok and colleagues examined outcomes in 52 patients (mean age 76.3 years) with 61 unresectable primary lung cancers of mean diameter 23.8 mm (range 26 to 55 mm). All the patients underwent MWA between July 2010 and June 2016.
The researchers found that local control was 88% at a 14 month time period by Kaplan-Meier analysis. Local tumor progression was diagnosed in six lesions (10%) and the median time to local recurrence was 3 months (range 2 to 14 months). The study also showed that if the lesion was larger than 3 cm there was a nearly 12-fold increase risk of local recurrence.
There were no intraprocedural deaths and no deaths reported during the 30-day post-ablation period. The median inpatient stay was only 1 day. The study showed that 22% of patients experienced a pneumothorax requiring a drain. The presence of severe emphysema and predicted forced expiratory volume in 1 second (FEV1) of less than 50% were found to predict future requirement of a drain when the researchers adjusted for age and gender.
- Tsakok MT, Little MW, Hynes G, et al. Local control, safety, and survival following image-guided percutaneous microwave thermal ablation in primary lung malignancy [published online November 14, 2018]. Clin Radiol. doi: 10.1016/j.crad.2018.09.014