| RFA is not a new technology; the method has been used for decades to treatbenign bone tumors and cardiac arrhythmia. RFA devices are currentlyFDA-approved to treat liver tumors that are not eligible for surgery, painfulbone tumors, and other soft-tissue tumors. Liver Currently, RFA is most frequently used to eliminate both primary and metastaticliver tumors between 0.5 and 3 cm in size. It is most effective when there areno more than three tumors per site. With more widespread disease, the treatmentis less effective at prolonging life. In many cases, RFA is used to reduce or eliminate pain caused by tumors, not tocure the cancer itself. However, researchers in Italy have found that thesurvivability rates for patients whose liver tumors were treated with RFA aresimilar to, if not better than, those for patients whose tumors were treatedwith surgery. These researchers and others are beginning to recommend RFA as thefirst-line treatment for all liver tumors. In addition, new research suggests that RFA in combination with other therapiescan treat larger tumors of the liver. A study from Memorial Sloan-KetteringCancer Center found that a combination of chemoembolization and RFA was aseffective as surgery in treating single primary liver tumors.
RFA has been used for years to destroy painful benign bone tumors, and thetechnique has now been expanded to attack malignant tumors. Unlike its use in soft-tissue tumors, RFA is used almost exclusively as apalliative remedy to improve quality of life, not as a way to increasesurvivability rates. The technique may completely eliminate small tumors lessthan 3 cm in size, but it can also be used to shrink tumors up to 10 cm indiameter. Both RFA and cryoablation have been shown to reduce pain caused by bone tumors.Research presented at the 2005 Society of Interventional Radiology conferenceshowed that RFA and cryoablation can reduce pain by as much as 89% in patientswith nonresectable bone tumors. Lung A recent study in Italy indicated that RFA of lung tumors can dramaticallyincrease survivability rates without decreasing quality of life. Doctors foundthat RFA killed tumors in the lung in 93% of cases, and patients hadcancer-specific one- and two-year survival rates of 91%. Five-year survivability rates from multicenter trials are not yet available.Some limited studies show cancer-specific five-year survivability rates of up to60%. Kidney RFA is most effective on kidney tumors between 0.5 and 3 cm in size, and no morethan three in number. The technique is promising, but long-term studies areneeded to prove how effective it is. The procedure has not been performed long enough or widely enough to producemulticenter five-year survivability data. However, research at MassachusettsGeneral Hospital found that RFA shows promise for treating kidney tumors nearthe surface of the organ. The investigators followed 34 patients over a 3.5-yearperiod and found that 31 of 42 kidney tumors—all located near the kidneysurface—were completely destroyed with RFA. | ||
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Breast Surgery is still the gold standard for treatment of breast tumors, butresearchers are seeing advantages to RFA treatment. It can be used both toeliminate small tumors in the breast and to reduce the size of larger tumors,making surgery easier and less disfiguring. Some researchers suggest that RFA may be a viable replacement for lumpectomy,but results of long-term studies are pending. Where RFA Should Not Be Used • Blood vessels • Nerve endings |
