The Role of Radiofrequency Ablation in the Treatment of Stage 1 Non-Small Cell Lung Cancer

  • John M. Varlotto
  • Julia A. Shelkey
  • Rickhesvar P. Mahraj
Part of the Medical Radiology book series (MEDRAD)


Currently, the standard of care for stage I non-small cell lung cancer (NSCLC) is surgical resection. Although this treatment modality has been demonstrated to have 5 year survival rates approaching 80%, there need to be effective alternative treatments for patients who are medically inoperable. Radiofrequency ablation (RFA) has emerged as a minimally-invasive therapy to fill this void. This modality has been found to be most effective for treatment of small (<3 cm), peripheral lesions that are located distal to vasculature, large airways, and the mediastinum. The most common complications after RFA include pneumothorax, pneumonia, and pleural effusion. To date, accurate assessment of the efficacy of RFA has been difficult to determine due to short follow-up times of current studies and the lack of standard definitions of local recurrence as well as toxicity. Current literature has suggested local progression rates ranging from 20 to 42%, but assessment by prospective trials with long-term follow-up and standardized definitions of toxicity and local control are needed to determine the true benefit of this procedure.


Radiofrequency Ablation Stereotactic Body Radiation Therapy Ablation Zone Local Progression Ablation Margin 



Automatic implantable cardioverter defibrillator


Ablation zone




Complete ablation


Complete necrosis


Complete response


Cancer specific survival


Common terminology criteria for adverse events


Disease-free survival


Distal recurrence


Endobronchial ultrasound


Extrapulmonary recurrence




Ground-glass attenuation


Hematoxylin and eosin staining

H&M nodes

Hilar and mediastinal nodes


Incomplete ablation


Intrapulmonary recurrence


Local control


Local recurrence


Monoclonal anti-mitochondrial antibodies




Not stated


Non-small cell lung cancer


Progression-free survival


Percutaneous biopsy






Response evaluation criteria in solid tumors




Radiofrequency ablation


External beam radiotherapy




Radiation therapy oncology group




Stereotactic body radiation therapy


Supravital blue staining


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Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • John M. Varlotto
    • 1
  • Julia A. Shelkey
    • 1
  • Rickhesvar P. Mahraj
    • 2
  1. 1.Radiation Oncology—CH63Penn State Hershey Cancer InstituteHersheyUSA
  2. 2.Department of RadiologyPenn State Hershey Medical CenterHersheyUSA

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