肺癌に対するラジオ波焼灼療法

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Radiofrequency ablation (RFA) is rapidly gaining popularity as a treatment of primary and secondary lung cancer. Inclusion criteria for this treatment include nonsurgical candidates, absence of coagulopathy, severe dysfunction of vital organs, uncontrollable extrapulmonary cancer, and coagulopathy. Number and size of tumors may be ≤ 3 per lung and ≥ 3cm, respectively. Techniques for lung RFA are quite similar to those of percutaneous lung biopsy. Local efficacy of lung RFA depends mainly on tumor size, but not on tumor type. Acquisition of an adequate ablative margin may be a key for local control. Local failure may be salvaged by repeating RFA. Survival rates after RFA are quite promising for patients with clinical stage I non–small cell lung cancer and pulmonary metastasis from colorectal cancer, hepatocellular carcinoma, and renal cell carcinoma. Although lung RFA is generally safe with a mortality rate of <1%, it may cause various complications. The most common complication is pneumothorax. Although most complications can be minor, the physicians should acknowledge and pay attention to rare but serious complications, which include massive hemorrhage, intractable pneumothorax, pulmonary artery pseudoaneurysm, systemic air embolism, pneumonitis, injury of the nearby tissues (e.g., brachial nerve plexus, phrenic nerve, diaphragm, and chest wall), and needle-tract seeding.
一般社団法人日本インターベンショナルラジオロジー学会の論文

肺癌に対するラジオ波焼灼療法

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