Brachytherapy
Volume 10, Issue 3 , Pages 253-259, May 2011

Combined radiofrequency ablation and high–dose rate brachytherapy for early-stage non–small-cell lung cancer

  • Michael D. Chan

      Affiliations

    • Department of Radiation Oncology, The Warren Alpert Medical School, Brown University, Providence, RI
    • Corresponding Author InformationCorresponding author. Department of Radiation Oncology, The Warren Alpert Medical School, Brown University, 593 Eddy Street, Providence, RI 02903. Tel.: +1-401-444-8311; fax: +1-401-444-5335.
    • ,
  • Damian E. Dupuy

      Affiliations

    • Department of Diagnostic Imaging, The Warren Alpert Medical School, Brown University, Providence, RI
    • ,
  • William W. Mayo-Smith

      Affiliations

    • Department of Diagnostic Imaging, The Warren Alpert Medical School, Brown University, Providence, RI
    • ,
  • Thomas Ng

      Affiliations

    • Department of Surgery, The Warren Alpert Medical School, Brown University, Providence, RI
    • ,
  • Thomas A. DiPetrillo

      Affiliations

    • Department of Radiation Oncology, The Warren Alpert Medical School, Brown University, Providence, RI

Received 30 March 2010; received in revised form 12 July 2010; accepted 19 July 2010. published online 27 August 2010.

Abstract 

Purpose

This retrospective analysis reports the results of patients with early-stage inoperable non–small-cell lung cancer treated with radiofrequency ablation (RFA) followed by adjuvant high–dose rate (HDR) brachytherapy.

Methods and Materials

Seventeen medically inoperable patients with biopsy-proven Stage I non–small-cell lung cancer were treated with RFA followed by single fraction HDR brachytherapy. Brachytherapy catheters were inserted immediately after RFA, and one fraction of HDR brachytherapy was delivered on the same day. Doses of brachytherapy ranged from 14.4 to 20Gy (median, 18Gy). Patients were followed clinically and radiographically to determine tumor control and toxicity profile.

Results

Median followup time was 22 months. Of the 17 patients, 3 patients have recurred locally. Each of the patients with local recurrences was originally treated for T2 disease. In total, three of seven cases with T2N0 disease experienced local recurrences, whereas all 9 patients with T1 disease were controlled locally. Five of the 17 patients required a chest tube posttreatment, and 1 patient developed an empyema. There were no deaths within 1 month of treatment.

Conclusions

RFA followed by HDR brachytherapy yields excellent local control with an acceptable toxicity profile for patients with otherwise inoperable early-stage lung cancer.

Keywords: Lung cancer, Radiofrequency ablation, HDR brachytherapy

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 Financial disclosures: Dr. Dupuy receives grant support from the following sources: Angiodynamics, Veran Medical, Biotex, BSD Medical, and Medwaves. Dr. Dupuy also serves as a speaker and consultant for Convidien and as a consultant for Ethicon Endosurgery.

PII: S1538-4721(10)00297-7

doi:10.1016/j.brachy.2010.07.002

Brachytherapy
Volume 10, Issue 3 , Pages 253-259, May 2011

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