Frying tumors can boost lung cancer survival
Updated: 2008-03-18 09:08
MONDAY -- Needle-delivered frying or freezing technologies can be useful weapons against both lung and kidney cancers, new research shows.
In one study conducted in France, patients with advanced lung cancer who were not candidates for surgery underwent a procedure known as radiofr equency ablation (RFA), which basically heats the tumors and kills them.
Seventy percent of the patients with lung metastases or primary non-small cell lung cancer were still alive after two years -- similar to results seen after surgery.
Furthermore, 85 percent of patients with non-small cell primary lung cancer treated with RFA had no viable tumors visible on imaging one year later, while 77 percent had no viable tumors after two years.
"It means that you can actually do a very good job of local control of lung tumors in patients who aren't fit for surgery," said Dr. Damian Dupuy, a professor of diagnostic imaging at Warren Alpert Medical School at Brown University and director of tumor ablation at Rhode Island Hospital in Providence.
"The medical establishment, being very conservative, has always said if you aren't fit for surgery you just basically get chemo and radiation and most of the time [they] don't work well and you die of your tumor. But even the most unfit for surgery can have this procedure safely," Dupuy said.
The Brown researcher was not involved in the French study, but his group completed a lung cancer trial last year with similarly good results.
The new study, led by Dr. Thierry de Baere of Institute Gustave Roussy, in Villejuif, France, was to be presented Monday at the annual meeting of the Society for Interventional Radiology in Washington, D.C.
Lung cancer is the number one cancer killer in the United States and a full 25 percent of patients who have operable disease can't undergo surgery because of co-existing conditions, Dupuy noted.
"This is a huge advance for them," he said. "This procedure is done at almost every hospital that has an interventional radiologist, which is most. It's like a lung biopsy."
"If you have to stick a needle in to diagnose lung cancer anyway, why not do it in a single sitting?" Dupuy asked.
Most patients go home the same day, he noted. According to Dupuy, the p rocedure may also hold promise for pain relief in patients who are dying.
Two other studies presented at the meeting used the other end of the temperature spectrum -- cryoablation -- to successfully freeze and kill kidney cancer tumors.
"This is a minimally invasive, non-surgical cancer treatment without an incision, explained Dr. Christos S. Georgiades, lead author of one of the studies and an assistant professor of radiology and surgery at Johns Hopkins Hospital in Baltimore. "You put a probe, which is basically a needle, into the tumor, freeze the central volume of the tissue with temperatures close to negative 150 degrees centigrade. The patients don't feel the cold."
In Georgiades' study, the procedure was 95 percent effective for tumors 4 centimeters or smaller and almost 90 percent effective in tumors up to 7 centimeters in diameter after one year. This was in patients with disease that had not yet spread beyond the kidney, he noted.
"The technique has been around for a few years, but we're only now proving that it works," Georgiades said. "Patients have recovery close to that of surgery and many do not have to have surgery. Many procedures are done on an outpatient basis."
The third study, from the Barbara Ann Karmanos Cancer Institute in Detroit, looked at tumors treated with cryoablation whose average size was 2.8 centimeters. After 1.3 years, most of the tumors still came up on imaging as dead tissue, the team found.
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