Percutaneous ablation of lung tumors is a minimally invasive therapy for patients with primary or metastatic cancer Not surgical candidates- cardiopulmonary comorbidities such as severe chronic obstructive pulmonary disease- patients who have limited pulmonary function - Pulmonary function is generally not significantly changed after thermal ablation. In fact, even in post-pneumonectomy patients with a single lung, RF ablation may be safely performed with preservation of pulmonary function Standard therapy fails肺癌微波消融适应症：应该和肺癌射频消融的适应症一样。文献一直在强调inoperable，或者说medically inoperable cases and high-risk early stage Nsclc 是热消融的适应症，包括解剖和内科原因不适合外科手术。  但是否存在Alternative to surgery in early stage NSCLC—interventional radiologic approaches 这一路径呢？即：病变是operable的cases拿来做热消融呢。  The standard of care for operable patients with early stage non-small cell lung cancer (NSCLC) is lobectomy with lymph node evaluation. However, a significant number of patients with early stage NSCLC are not candidates for lobectomy due to diminished pulmonary function and other comorbidities. For non-surgical candidates, stereotactic body radiation therapy (SBRT) or image-guided percutaneous thermal ablation are attractive options.（有吸引力的选择）In recent years, microwave ablation and cryoablation have also been applied with increasing frequency. Percutaneous thermal ablation offers may advantages including:- minimally invasive nature- ability to preserve normal lung parenchyma with minimal effect on pulmonary function, - ability to perform these procedure under moderate sedation or even local anesthesia - most procedures are performed in a single outpatient session and can even be done at the same time as a biopsy - percutaneous thermal ablation allows for repeated treatment sessions, which may improve survival in patients who have failed primary treatment - percutaneous thermal ablation allows for repeated treatment sessions, which may improve survival in patients who have failed primary treatment - Repeated surgery, on the other hand, is often not feasible secondary to either technical difficulty or limited residual pulmonary reserves - SBRT is similarly limited in regards to retreatment of local tumor recurrence secondary to limitations in maximal tolerated radiation dosages to the lung for fear of radiation pneumonitis. - Another limitation of some types of SBRT is the need for multiple gold fiducial markers, which are placed percutaneously or bronchoscopically. Percutaneous placement of fiducial markers is associated with higher complication rates than percutaneous thermal ablation |
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