الفهرس 
What causes lung cancerOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
Percutaneous image-guided thermal ablation with radiofrequency energy is a minimally invasive procedure that has emerged as a viable alternative or complementary treatment option for patients with primary and secondary pulmonary malignancies (Abtin, et al , 2012).
While surgery remains the treatment of choice for early lung cancer, only 20-30% of lung cancer patients are feasible for surgical treatment in clinical settings. The proportions of elderly and middle-aged lung cancer patients continue to rise as the population ages. These patients often are accompanied by other conditions and therefore are not feasible or can not tolerate the conventional surgical resection. (Liu and Zhi, 2015).
Also, as a local minimally invasive ablation technique, RFA may be combined with other treatment (e.g., radiotherapy and systemic therapy) to improve the efficacy (Liu and Zhi, 2015).
The RF ablation has the following advantages in the treatment of lung tumors: minimal invasiveness, definite efficacy, high safety, fast recovery, relatively simple operation, and wide applicability. (Liu and Zhi, 2015).
In our study, 30 cases undergone RFA with 100 % technical success rate. Minimal complications were noted after finishing the procedure.
According to Lencioni et al., RF ablation can be considered when the tumor is ≤ 3 - 3.5 cm in diameter and the tumor is located at least 1 cm from trachea, main bronchi, esophagus (Lencioni et al., 2008).
Yamakado et al demonstrate tumors of up to 3 cm in diameter and located in the periphery of the lung are the ideal candidates for RFA. (Yamakado et al., 2007).
In our study, patients were selected with their lung lesions size equal or less than 2 cm. Study lesions were 35 lesions that were ablated guided by CT.
In consideration with Liu and Zhi , Complete ablation is achieved if there is any of the following findings on CT: the target tumor disappears; without cavity, solid nodules, atelectasis, or fibrosis on enhanced images. Or, PET-CT indicates that the target tumor has no radionuclide enrichment or has normal SUV value (Liu and Zhi, 2015).
According to Abtin et al, Contrast-enhanced CT, PET, and PET/CT should be used in conjunction as routine follow-up or as problem-solving modalities, especially when CT findings are equivocal. (Abtin et al, 2012).
In our study, all patient had routine follow up after ablation using CT scan with contrast in 3 months intervals and PET/CT scan in 6 months and 1 year intervals. Also PET/CT scan was done immediately after RFA for Some patients. About 29 from 35 ablated lesions achieved well ablation criteria with total loss of FDG activity in the 1 year post ablation PET/CT with curative rate = 83%
Our study conclusion, RFA is not intended to replace surgery, radiation therapy or chemotherapy in all patients. It may be effective when used alone or in conjunction with these treatments. RFA is considered a relatively safe procedure with an extremely low mortality rate or major complications in form of severe pneumothorax that necessitates intubation. With refinements in technology, patient selection, clinical applications, and methods of follow-up, RFA may continue to flourish as a potentially viable stand-alone or complementary therapy for both primary and secondary lung malignancies in standard and high-risk populations.