Radiofrequency ablation for intrathoracic malignant tumors

Objectives. Radiofrequency ablation (RFA) is now recognized as one of the most effective minimally invasive therapeutic options for localized malignant diseases, especially hepatic tumors. We applied this technique for the treatment of malignant tumors in the thoracic cavity. Patients and Methods. Seven patients underwent 14 RFA sessions for 22 intrathoracic tumors from June 2001 through March 2002. Using computed tomographic fluoroscopy guidance, RFA was done with 17-gauge Cool-tip needles inserted into the tumors, Results. The underlying diseases of these patients were 6 cases of metastatic pulmonary tumors and a case of disseminated pleural tumors of diameters ranging from 8 to 55 mm. There were complications including mild pain, pneumothorax, high fever, and pleural effusion, but most of them could be controlled easily. In one patient drainage was necessary for massive pleural effusion following ablation for disseminated pleural tumors of 55 mm in diameter. Following RFA, two of 22 nodules were enhanced on dynamic enhanced CT, and there were some viable tumor cells in seven nodules in specimens of CT-guided needle biopsy. We performed re-ablation for four of these nodules. We lost one patient due to pneumonia seven months after the procedure, while the other six patients are alive but still have tumors. Conclusions. RFA may become a less-invasive, safe, and effective therapeutic option for intrathoracic malignant tumors.