I was lucky enough to train doing lung ablations while I was a fellow. I have incorporated a lung ablation program at our institute.
There is a prospective trial called the RAPTURE trial by Ricardo Lencioni that was published in Lancet Oncology. I recommend those who are interested in reviewing this.
The primary indications are unresectable Stage I lung cancers and oligomets often from colorectal cancer.
There are some noninvasive alternatives including radonc and SBRT. Sometimes these patients have been radiated and can no longer have additional radiation dose.
At Brown , Dr. Dupuy has done some interesting work with pulmonary ablation in combination with radiation therapy.
The main issues I see with this technique is that there are some risks including hemoptysis and pneumothorax that may require a chest tube. The patients that we often get referred have significant comorbidities and poor FEV1s.
I follow these patients with PET CT imaging at 1 mo, 6 mo and then yearly. I have seen some recurrences which I will reablate (targeting the PET positive component). Hope that helps.
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