Skip to main content
SpringerLink
Log in

Radiofrequenzablation von Lungentumoren und -metastasen

Radiofrequency ablation of tumors or metastases of the lung

  • Thermotherapie
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Zielsetzung

Die Radiofrequenzablation (RFA) wird zunehmend bei Tumoren außerhalb der Leber eingesetzt. Ziel der vorliegenden Arbeit ist es, eigene Ergebnisse bei der Behandlung von Lungentumoren mit bislang zu diesem Thema erschienenen Publikationen zu vergleichen.

Material und Methoden

Innerhalb von 18 Monaten wurden an unserem Institut 16 Patienten mit Lungentumoren mittels RFA behandelt, davon 8 im Rahmen einer internationalen Multicenterstudie. Für diesen Artikel wurden unsere mit den Ergebnissen verglichen, die in seit 1995 erschienen Publikationen beschrieben wurden.

Ergebnisse

Bei 8 von uns außerhalb der Studie behandelten Patienten traten während des Beobachtungszeitraums von bis zu 15 Monaten 2 Tumorrezidive auf, wogegen 6 Patienten rezidivfrei blieben. Lee et al. berichten über 30 Patienten, von denen nur 10 in kurativer Intention behandelt wurden. 8 dieser 10 Patienten waren nach einem Jahr rezidivfrei. Steinke et al. untersuchten 24 Patienten mit Lungenmetastasen kolorektaler Karzinome, von denen 19 Patienten mit insgesamt 41 Läsionen über ein Jahr beobachtet wurden, wobei es nur bei 8 der 41 Läsionen zu einem Tumorrezidiv kam. Die von Lencioni et al. präsentierten Zwischenergebnisse der oben genannten Multicenterstudie zeigen eine Tumorkontrolle bei 77 von 84 Patienten nach 6 Monaten und eine Rezidivfreiheit bei allen 26 der über ein Jahr nachverfolgten Patienten.

Diskussion

Die Ergebnisse mit einem Jahr Beobachtungszeitraum sprechen dafür, dass die RFA für Tumoren, die kleiner als 3 cm sind, eine Therapiealternative zur klassischen chirurgischen Behandlung sein könnte, bei deutlich geringerer Morbidität und Mortalität. Für eine definitive Bewertung müssen aber die Ergebnisse längerfristiger Studien abgewartet werden.

Abstract

Background and purpose

Radiofrequency ablation is increasingly used to treat tumors “beyond the liver”. The aim of this article is to perform a structured and critical review of the current literature concerning RFA of the lung and to compare these results with our own experience.

Material and methods

16 patients with tumors or metastases of the lung were treated in our institution within 18 months. 8 of these 16 patients were treated in a multicenter trial. For this article we compared our results to the results of all publications concerning RFA of the lung since 1995.

Results

8 of our 16 patients were not included in the international multicenter trial and were followed-up at least 15 months. Within this observation period, 2 of 8 patients had recurrence of the tumors while in 6 patients no recurrence was detected. Lee et al. published a study with 30 patients. In 10 of these 30 patients RFA was performed in a curative intention with a therapeutical success in 8 of 10 patients after one year.

Discussion

Radiofrequency ablation of lung tumors smaller than 3 cm appears to be an alternative to surgical removal. Moreover, RFA offers a higher quality of life for the patients due to a low morbidity and mortality. However, more studies with longer observation periods are necessary for a definite conclusions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Burak WE jr, Agnese DM, Povoski SP, Yanssens TL, Bloom KJ, Wakely PE, Spigos DG (2003) Radiofrequency ablation of invasive breast carcinoma followed by delayed surgical excision. Cancer 7:1369–1376

    Article  Google Scholar 

  2. Crowley JD, Shelton J, Iverson AJ, Burton MP, Dalrymple NC, Bishoff JT (2001) Laparoscopic and computed tomography-guided percutaneous radiofrequency ablation of renal tissue: acute and chronic effects in an animal model. Urology 5:976–980

    Article  Google Scholar 

  3. Curley SA (2003) Radiofrequency ablation of malignant liver tumors. Ann Surg Oncol 4:338–347

    Article  Google Scholar 

  4. Dupuy DE, Zagoria RJ, Akerley W, Mayo-Smith WW, Kavanagh PV, Safran H (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 1:57–59

    Google Scholar 

  5. Goldberg SN, Gazelle GS, Compton CC, McLoud TC (1995) Radiofrequency tissue ablation in the rabbit lung: efficacy and complications. Acad Radiol 9:776–784

    Google Scholar 

  6. Herrera LJ, Fernando HC, Perry Y, Gooding WE, Buenaventura PO, Christie NA, Luketich JD (2003) Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates. J Thorac Cardiovasc Surg 4:929–937

    Article  Google Scholar 

  7. Hicks RJ, Kalff V, MacManus MP, Ware RE, Hogg A, McKenzie AF, Matthews JP, Ball DL (2001) (18)F-FDG PET provides high-impact and powerful prognostic stratification in staging newly diagnosed non-small cell lung cancer. J Nucl Med 11:1596–1604

    Google Scholar 

  8. Hsu TH, Fidler ME, Gill IS (2000) Radiofrequency ablation of the kidney: acute and chronic histology in porcine model. Urology 5:872–875

    Article  Google Scholar 

  9. Janzen N, Zisman A, Pantuck AJ, Perry K, Schulam P, Belldegrun AS (2002) Minimally invasive ablative approaches in the treatment of renal cell carcinoma. Curr Urol Rep 1:13–20

    Google Scholar 

  10. Lee JM, Kim SW, Li CA, Youk JH, Kim YK, Jin Z, Chung MJ, Lee MS (2002) Saline-enhanced radiofrequency thermal ablation of the lung: a feasibility study in rabbits. Korean J Radiol 4:245–253

    Google Scholar 

  11. Lee JM, Youk JH, Kim YK, Han YM, Chung GH, Lee SY, Kim CS (2003) Radio-frequency thermal ablation with hypertonic saline solution injection of the lung: ex vivo and in vivo feasibility studies. Eur Radiol 11:2540–2547

    Article  Google Scholar 

  12. Lee JM, Jin GY, Goldberg SN, Lee YC, Chung GH, Han YM, Lee SY, Kim CS (2004) Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology 1:125–134

    Google Scholar 

  13. Liu C, Frilling A, Dereskewitz C, Broelsch CE (2003) Tumor seeding after fine needle aspiration biopsy and percutaneous radiofrequency thermal ablation of hepatocellular carcinoma. Dig Surg 5:460–463

    Article  Google Scholar 

  14. Liu LX, Jiang HC, Piao DX (2002) Radiofrequence ablation of liver cancers. World J Gastroenterol 3:393–399

    Google Scholar 

  15. Llovet JM, Vilana R, Bru C, Bianchi L, Salmeron JM, Boix L, Ganau S, Sala M, Pages M, Ayuso C, Sole M, Rodes J, Bruix J (2001) Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 5:1124–1129

    Article  Google Scholar 

  16. Lu DS, Raman SS, Vodopich DJ, Wang M, Sayre J, Lassman C (2002) Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: assessment of the „heat sink“ effect. AJR Am J Roentgenol 1:47–51

    Google Scholar 

  17. Nishida T, Inoue K, Kawata Y, Izumi N, Nishiyama N, Kinoshita H, Matsuoka T, Toyoshima M (2002) Percutaneous radiofrequency ablation of lung neoplasms: a minimally invasive strategy for inoperable patients. J Am Coll Surg 3:426–430

    Article  Google Scholar 

  18. Passlick B (2003) Initial surgical staging of lung cancer. Lung Cancer:21–25

    Google Scholar 

  19. Pope RJ, Hansell DM (2003) Extra-thoracic staging of lung cancer. Eur J Radiol 1:31–38

    Article  Google Scholar 

  20. Rose DM, Allegra DP, Bostick PJ, Foshag LJ and Bilchik AJ (1999) Radiofrequency ablation: a novel primary and adjunctive ablative technique for hepatic malignancies. Am Surg 11:1009–1014

    Google Scholar 

  21. Schaefer O, Lohrmann C, Ghanem N, Langer M (2003) CT-guided radiofrequency heat ablation of malignant lung tumors. Med Sci Monit 11:MT127–131

    Google Scholar 

  22. Schaefer O, Lohrmann C, Langer M (2003) CT-guided radiofrequency ablation of a bronchogenic carcinoma. Br J Radiol 904:268–270

    Article  Google Scholar 

  23. Shankar S, van Sonnenberg E, Silverman SG, Tuncali K, Morrison PR (2003) Management of pneumothorax during percutaneous radiofrequency ablation of a lung tumor: technical note. J Thorac Imaging 2:106–109

    Article  Google Scholar 

  24. Steinke K, Glenn D, King J, Morris DL (2003) Percutaneous pulmonary radiofrequency ablation: difficulty achieving complete ablations in big lung lesions. Br J Radiol 910:742–745

    Article  Google Scholar 

  25. Steinke K, King J, Glenn D, Morris DL (2003) Percutaneous radiofrequency ablation of lung tumors: difficulty withdrawing the hooks resulting in a split needle. Cardiovasc Intervent Radiol

    Google Scholar 

  26. Steinke K, King J, Glenn D, Morris DL (2003) Radiologic appearance and complications of percutaneous computed tomography-guided radiofrequency-ablated pulmonary metastases from colorectal carcinoma. J Comput Assist Tomogr 5:750–757

    Article  Google Scholar 

  27. Suh RD, Wallace AB, Sheehan RE, Heinze SB, Goldin JG (2003) Unresectable pulmonary malignancies: CT-guided percutaneous radiofrequency ablation—preliminary results. Radiology 3:821–829

    Google Scholar 

  28. Tacke J (2003) [Percutaneous radiofrequency ablation—clinical indications and results]. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2:156–168

    Article  Google Scholar 

  29. Vansteenkiste JF (2002) Imaging in lung cancer: positron emission tomography scan. Eur Respir J [suppl]:49s–60s

  30. Wood BJ, Ramkaransingh JR, Fojo T, Walther MM, Libutti SK (2002) Percutaneous tumor ablation with radiofrequency. Cancer 2:443–451

    Article  Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum Großhadern der Universität München

    R. T. Hoffmann, T. F. Jakobs, M. F. Reiser & T. K. Helmberger

  2. Institut für Klinische Radiologie, Klinikum Großhadern der Universität, Marchioninistr. 15, 81377 , München

    R. T. Hoffmann

Authors
  1. R. T. Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. F. Jakobs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. F. Reiser
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. K. Helmberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. T. Hoffmann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hoffmann, R.T., Jakobs, T.F., Reiser, M.F. et al. Radiofrequenzablation von Lungentumoren und -metastasen. Radiologe 44, 364–369 (2004). https://doi.org/10.1007/s00117-004-1029-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-004-1029-5

Schlüsselwörter

Keywords

Search

Navigation