Thermal Ablation vs Stereotactic Radiotherapy in Early-Stage NSCLC
Thermal ablation is a safe, effective treatment for early-stage non–small cell lung cancer (NSCLC), with comparable results to traditional stereotactic radiotherapy, according to a study published by Uhlig et al in the journal Radiology. The results show that ablation may be an effective alternative for patients with lung cancer who cannot undergo surgery because of age or health status.
Surgery is the treatment of choice for early-stage NSCLC, but older patients and those with other conditions may not be ideal candidates due to a higher risk of complications. Stereotactic radiotherapy (SRT), in which tumor cells are destroyed with targeted doses of radiation, is a viable alternative in these patients, but the radiation sometimes harms healthy tissue surrounding the tumor and carries a risk of short-term and long-term toxicities.
Thermal ablation, in which a probe is inserted directly into the tumor under precise imaging guidance, offers another treatment option applied in the form of extreme heat, extreme cold, or radio waves to destroy the tumor.
“Thermal ablation is most often a one-time treatment, unlike SRT, which requires multiple visits,” said study senior author Hyun S. ‘Kevin’ Kim, MD, of Yale Cancer Center and Yale School of Medicine. “In addition, ablation delivers highly accurate and precise localized treatment only to cancer cells, minimizing the effects to surrounding tissue and keeping toxicity low.”
Study Findings
Dr. Kim, head of the Interventional Oncology Program at Yale, led a multidisciplinary team of thoracic oncology investigators in comparing thermal ablation and SRT for the treatment of early-stage NSCLC. The study group included almost 29,000 patients from the National Cancer Database treated between 2004 and 2013, including more than 1,100 who had undergone thermal ablation. Researchers compared outcomes over several years.
Both treatment methods delivered comparable performance in terms of survival rates. The 2-year survival rate in the thermal ablation group was slightly more than 65%, compared with 64.5% for the SRT group. At 5 years, survival rates were just below 25% for the thermal ablation group and slightly more than 26% for the SRT group.
“The outcomes for patients who received thermal ablation for early lung cancer were quite similar to those who received SRT,” Dr. Kim noted.
Other advantages of thermal ablation include direct access to the tumor itself, which enables physicians to collect biopsy samples during the procedure—an option not available with SRT. “This is a real value to our patients, especially as tissue sampling becomes more and more important in personalized, precision cancer treatments,” Dr. Kim said.
The one-time treatment also has lower direct costs for patients and insurance providers, Dr. Kim said, and could prove to be a more cost-effective alternative to radiation therapy.
The researchers are planning further study of thermal ablation's potential role in the total care of patients with lung cancer.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
