Irreversible Electroporation of Lung Tumors

Abstract

Lung and bronchial cancer has the second highest incidence of new diagnosis in cancer patients and is the cause of the largest number of patient deaths due to cancer in the last decade. In addition to primary disease, lung is a common site for metastatic disease from colorectal cancer, breast cancer, and melanoma [1]. Partial (lobectomy) or complete resection of the lung remains the gold standard for treating this disease. However, surgery reduces lung capacity and results in significant reduction in quality of life in the postsurgical setting. Image-guided ablation is a suitable alternative to patients for whom surgery is contraindicated as this treatment approach can preserve lung volume and function and allow re-treatment in case of recurrent or metachronous disease. Ablation can be performed as a same day discharge procedure with minimal loss of lung function. When used as palliation, ablation will not impact quality of life associated with recovery from a surgical procedure. Unlike surgery, chemotherapy need not be interrupted, and image-guided therapy may also support treatment at earlier time points while avoiding risk of undesirable symptoms. Finally, ablation presents a lower technical burden to physicians and resource limited hospitals and therefore may be well suited for wider use. Ablation techniques that induce significant alterations in temperature of the targeted tissue are currently used to treat tumors in the lung. Such thermal ablation techniques pose certain efficacy limitations and risks that necessitate investigation of alternate ablation therapies for use in the lung. Irreversible electroporation (IRE) has the potential to overcome these limitations and serve as an important option for treatment of primary and metastatic disease in the lung.