Image-guided tumor ablation for the treatment of recurrent non-small cell lung cancer within the radiation field

PURPOSE: The treatment options for non-small-cell lung cancer (NSCLC) that recurs after irradiation are limited. Image-guided percutaneous thermal ablation is an effective option in treating NSCLC that may provide an alternative to reirradiation. The purpose of this paper is to determine the survival and palliative benefit of image-guided percutaneous thermal ablation in the treatment of NSCLC that recurred within the treatment field of prior external beam radiation therapy. METHODS: Twenty patients, median age 70, who had NSCLC recurrences following irradiation were treated with image-guided thermal ablation. Kaplan-Meier analysis was used to assess survival benefit and subjective pain reports were used to investigate pain relief. RESULTS: The median survival time was 13.1±SE 1.4 months and the median survival time without local recurrence was 8.5±1.6 months. Eight patients (40%) recurred locally after a median of 3.3 months. Seven out of ten patients (70%) presenting with significant pain had decreased pain at initial post-ablation evaluation. Following the 25 ablations, there were no Grade IV or V, 1 Grade III, 3 Grade II, and 23 Grade I complications. CONCLUSION: Thermal ablation offers a potential survival benefit compared with other available modalities for the treatment of NSCLC recurring within a previously irradiated field. This promising technique has a good safety profile and may also be useful in providing symptomatic relief.