الفهرس | Only 14 pages are availabe for public view |
Abstract Pulmonary RFA has become a highly appealing, minimally invasive treatment option that has been widely adopted to treat primary and secondary lung tumors. Many patients with lung cancer are not appropriate candidates for RF ablation because they have extensive extra pulmonary tumor involvement or have tumors that are too large, too numerous, or dangerously located, or they are candidates for surgical resection, which is historically their best opportunity for long-term survival. However, a significant number of patients may benefit from RF ablation. When potential cure is the therapeutic goal. RF ablation is best used in patients who are not amenable to surgery with stage I NSCLC and patients with a limited number of small, slow growing metastases restricted to the lungs. Clearly, the best results in terms of complete tumor ablation are achieved in patients with lesions no larger than 3 cm in diameter. RF ablation may be used for patients with larger tumors, even though the likelihood of requiring subsequent RF ablation sessions is higher. In patients in whom palliation of tumor-related symptoms is the therapeutic goal , RF ablation frequently results in symptom improvement and may be used in patients with more advanced NSCLC tumors, larger tumors, or tumors that invade the chest wall and in patients with extra pulmonary malignancy. Optimal outcome of RF ablation in the lung, as with RF ablation in other locations, requires precise placement of electrodes to achieve complete and homogeneous distribution of thermal energy and to avoid unintended mechanical or thermal damage to nearby critical non targeted structures. Knowledge of the potential procedure-related complications and techniques to avoid them, and early recognition and Pageappropriate management, are fundamental to maintain the good safety profile for this technique that has been its primary advantage. RFA is considered a relatively safe procedure with an extremely low mortality rate or major complications in form of sever pneumothorax that necessitates intubation. 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. With refinements in technology, patient selection, clinical applications, and methods of follow-up, RFA will 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. |