New outpatient treatment may offer a new lease on life to some patients with inoperable lung cancer. More than 50% of patients with lung cancer treated with thermal ablation live for 3 years—2 years beyond their average life expectancy, according to results of a recent study (J Vasc Interven Radiol. 2006; 17:1117-1124).

Investigators recruited 41 patients with inoperable early stage (stage I-II) non– small-cell lung cancer. Of these, 27 underwent thermal ablation followed by external-beam radiation, and 14 underwent thermal ablation followed by interstitial brachytherapy. Some 97.6% of them were still alive at 6 months, 86.8% at 1 year, 70.4% at 2 years, and 57.1% at 3 years. At a median follow-up of 19.5 months, the average survival was 42.2 months. 

Patients with small tumors, <3 cm (n = 17), had the best outcomes, with an average survival of 44.4 months. In patients with larger tumors (n = 24), average survival was 34.6 months (P = .08). Localized recurrence occurred in 11.8% of tumors <3 cm, at an average of 45.6 ± 4.1 months, and in 33.3% of the larger tumors, at an average of 34.0 ± 7.8 months (P = .03).

Limitations of this study include its retrospective design and short follow-up. In addition, various types of thermal ablation and radiotherapy were used.

"Only one third of patients diagnosed with non– small-cell lung cancer are eligible for surgery; the rest face the reality of having less than 12 months to live," said lead author Damien Dupuy, MD, of Rhode Island Hospital. "These new outpatient treatments are not only effective but allow us to treat patients who historically have no other options."

Dr Dupuy added, "Utilizing imaging and targeting thermal ablation, we can heat and destroy lung tumors and extend a patient's life. As a physician, it's so gratifying to be able to provide a treatment that is so beneficial and so easy to undergo."

No treatment-related deaths were reported, and there were no episodes of acute toxicity after external-beam radiation therapy or brachytherapy.

"Percutaneous thermal ablation followed by radiotherapy appears to be well tolerated, with a low rate of complications that can often be managed on an outpatient basis," Dr Dupuy and colleagues write. Additional study is needed to determine the type of patients who would be the most suitable for combined treatment with thermal ablation and radiotherapy, they conclude.