Computed tomography-guided radiofrequency ablation and microwave ablation of non-small cell lung cancer metastases: Safety and efficacy in a real-world cohort

Introduction and Aim: Percutaneous computed tomography-guided (CT-guided) thermal ablation is a minimally invasive method for the treatment of adrenal metastases, painful bone metastases and liver metastases originating from non-small cell lung cancer (NSCLC). We aimed to further evaluate the safety and efficacy of CT-guided radiofrequency ablation (RFA) and microwave ablation (MWA) in the management of metastases in a real-life cohort of NSCLC patients. Methods: The medical records of 142 patients with metastatic NSCLC (71, 32 and 40 patients with adrenal metastases, painful bone metastases and liver metastases, respectively) treated with CT-guided RFA or MWA were retrospectively studied. The efficacy of thermal ablation was evaluated by post-ablation imaging. For painful bone metastases, palliation was assessed by the Brief Pain Inventory (BPI) score. Results: Technical success of CT-guided thermal ablation was 100%. No major complications occurred. Among patients with adrenal metastases treated with RFA or MWA, local recurrence was observed in 17.1% and 19.4% of cases at 1-year follow up, respectively. In patients with painful bone metastases, significant pain relief was noted after thermal ablation (p<0,001). Local recurrence was observed in 3.3% of cases with liver metastases at 1-year follow-up. Conclusion: CT-guided RF and MW ablation is a safe and effective local treatment for the management of adrenal, bone and liver metastases from NSCLC. For painful bone metastases RF ablation provides significant pain relief.