Ablation therapy for lung cancer

  With the use of percutaneous ablation in the liver, kidney, prostate and other organs, its application to lung tumors is also increasing. At present, the commonly used ablation techniques at home and abroad include thermal ablation, such as radiofrequency, microwave, laser, high-intensity focused ultrasound, and cold ablation techniques such as argon helium knife. The advantages of percutaneous ablation treatment are: accurate positioning and high efficacy; less trauma, low complications, almost no side effects; multiple lesions can be treated at one time, no limitation on the number of treatments; the difficulty is equivalent to lung puncture biopsy.  Indications At present, radiofrequency ablation has been reported for: 1. early stage lung cancer patients who refuse surgery, or those who are unable to tolerate surgery due to combined heart, lung and other important organ insufficiency 2. patients with middle to late stage primary lung cancer; lung cancer with metastasis from other parts of the body 3. patients whose lung cancer cannot be completely removed by surgery or recurred after surgery 4. various lung metastatic tumors  Contraindications: 1. Diffuse metastatic lesions in the lung 2. Pulmonary hilar lesions with large cavities 3. Central lung cancer combined with severe obstructive pneumonia 4. Pulmonary infection and large amount of pleural fluid 5. Severe failure of important organ functions such as severe cardiac, hepatic and renal insufficiency, pulmonary insufficiency resulting in inability to lie down and the patient’s physique cannot tolerate the RF process 6. Allergy to anesthetic drugs and coagulation Efficacy evaluation: Some studies have shown that the incidence of postoperative complications of grade 2 and grade 3 of radiofrequency ablation for stage I non-small cell lung cancer is 12% and 6%, respectively, and the overall survival rate, cancer-specific survival rate and disease-free survival rate at 1, 2 and 3 years are 94%, 100%, 82%, 86%, 93%, 64%, 74%, 80% and 53%, respectively. In the same data set of stage I non-small cell lung cancer, there was no statistically significant difference in mean survival time between patients undergoing surgical resection and radiofrequency ablation. A recent controlled group of studies found that for patients with stage I and II NSCLC, the median survival was 33, 8 months and 28, 2 months for surgery alone and radiofrequency alone, respectively, while for patients with stage III and IV NSCLC, the median survival was 29 and 42 months for chemotherapy alone or radiofrequency plus chemotherapy, respectively. This shows that radiofrequency ablation is recommended in the treatment of non-small cell atrial lung cancer.