Ablation therapy in lung cancer

S7B – Meet the Expert
ABLATION THERAPY IN LUNG CANCER

Ridzuan Abdul Rahim
National Cancer Institute, Putrajaya, Malaysia

Primary lung cancer is the leading cancer related death in both men and women with pulmonary metastasis the second most common site of metastases. Treatment of primary and secondary lung cancer is surgical resection, radiotherapy, chemotherapy and ablation therapy or combination. Percutaneous ablation therapy has a role in poor surgical candidate patients either due to limited pulmonary function or poor cardiopulmonary function. Ablation therapy is effective in the treatment of limited lung metastases not amenable for surgery. As radiotherapy has considerable side effects, and pulmonary metastatectomy has limitation due to medical co morbidities in potential patients, percutaneous ablation of lung tumors provide less complicated alternative for local tumor control rates as compared to chemotherapy alone. Percutanoeus ablation can be done under deep sedation or sometimes local anesthesia. The concept of treatment in which patient with multiple metastases undergo ablation therapy to treat large metastases leaving smaller ones to be treated by chemotherapy is applied in IKN for the treatment of metastatic lung cancer. Cryoablation therapy is a form of thermal ablation therapy apart from radiofrequency and microwave ablation therapy. Under certain conditions, thermal ablation therapies are as effective as surgical resection in local tumor control. Common sites suitable for cryoablation include lung, kidneys and bone. Features of cryoablation, that is reduced periprocedural pain as well as  presence of cryoresistant tissues, makes it the ablation modality of choice in certain cases of ablation therapy. Common complications include pneumothorax, pleural effusion and haemoptysis