Ablation techniques in non-small cell lung cancer patients: experience of a single center

Background: Percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) are well-established treatments for patients with non-small cell lung cancer (NSCLC). This study assessed the efficacy and safety of RFA and MWA performed on NSCLC patients. Material and Methods: This retrospective study included one hundred twenty-four patients with NSCLC who underwent percutaneous ablation from November 2014 to November 2020 in the Department of Medical Imaging and Interventional Radiology of Sotiria General Hospital for Chest Diseases in Athens, Greece. Forty (stage IA) were treated with RFA, while 84 were treated with MWA (stages IA, IB, and IIA). All procedures were performed using the AMICA GEN radiofrequency and microwave generator. As a follow-up method, computed tomography was performed immediately after the procedure to evaluate the lesion's response and complications and one, three, six, and twelve months after the ablation. Results: All ablations were technically successful. The first-month follow-up revealed stage IIA residual tumors in eight patients. Local recurrence was detected one year after RFA in two of the 40 patients and thirteen of the 84 patients after MWA. Overall survival (OS) rates at one, two, and three years for stage IA NSCLC patients treated with ablation were 94 %, 73 %, 57 % for RFA, and 96 %, 75 %, and 62 % for MWA, respectively. In contrast, the OS for stages IB and IIA patients treated with MWA was 90 %, 66 %, and 51 % for the IB stage and 82 %, 62 %, and 48 % for the IIA stage, respectively. Fifteen percent of patients after RFA and 9.5 % after MWA experienced minor complications. Pneumothorax was documented in three patients after RFA and four after MWA. Post-ablation syndrome occurred in 15 % of RFA patients and 8.3 % of MWA patients. There were no major complications. Conclusion: RFA and MWA have comparable efficacy and safety for patients in stage IA. MWA is an effective alternative treatment option for non-resectable IB or IIA stages NSCLC patients.