Role of Microwave Ablation in Treatment of Lung Tumors
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- Category: Vol. 88, June 2020
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Role of Microwave Ablation in Treatment of Lung Tumors, EMAD H.A. EMARA, MONA O. ABOELEZZ, HOSSAM EL DIN M. ABDEL RAHMAN, SAMEH S. BIOMY and THOMAS J. VOGL
Abstract
Background: Image-guided percutaneous thermal ablation is a common excellent alternative option for treatment of non-operable primary and metastatic lung tumors. These techniques are based on heating effect on the tissue around a percutaneous applicator causing coagulative necrosis of the tumor cells. Microwave Ablation (MWA) is a commonly used locoregional interventional procedure in treatment of pulmonary tumors with satisfactory outcome. Aim of Study: The aim of the study was to evaluate the role of CT-guided microwave ablation of inoperable lung tumors. Subjects and Methods: This study was carried out at Diagnostic & interventional Radiology Department, Goethe University Hospitals, Frankfurt, Germany during the period from April 2017 to March 2020, included 40 patients with 52 lung malignant lesions, underwent CT-guided microwave ablation. All patients were subjected to complete clinical examination, pre-procedural laboratory investigations & imaging evaluation. Post ablation follow-up by chest CT was done after 24 hours, three, six, nine months, one year and every 6 months onwards to determine treatment response. Patients were either adequately ablated (no residual tumor activity) or had local progression (residual tumor activity). Results: Forty-four malignant lesions (84.6%) showed complete response to treatment and 8 lesions (15.4%) had local progression (residual activity). The median time to local tumor progression was 8.3 months. The median survival was 32 months for patient underwent MWA according to the Kaplan-Meier test. The overall survival rate at 1, 2, and 3 years was 97.5%, 90%, and 82.5%, respectively. Successful tumor ablation was significantly more frequent for lesions with a maximal axial diameter of 3cm or smaller (p=.0001). There were no deaths during the procedure and the mortality rate within 6 months after ablation was 0%. Early postablation complications included pneumothorax (13.5%), pulmonary hemorrhage (9.6%) and postablation syndrome (3.85%), Pleural Effusion (3.85%), Hemoptysis (3.85%). Manual evac-uation was done in 3 cases out of 7 sessions complicated by pneumothorax. No significant long-term complications were detected.
Conclusion: Percutaneous CT-guided microwave ablation therapy for management of pulmonary tumors is safe and effective minimally invasive option and can improve local tumor control and survival rate in patients who are not candi-date for surgical resection.