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

Chan, Michael D; Dupuy, Damian E; Mayo-Smith, William W; Ng, Thomas; DiPetrillo, Thomas A

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 20 Gy (median, 18 Gy). 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.