2007 Volume 25 Pages 43-48
Recently, with an increasing uses of the high-resolution CT scan, the effectiveness of detecting tiny tumors in the peripheral lung, such as early stage lung carcinoma, small metastases, or atypical adenomatous hyperplasia, has increased. Video-assisted thoracic surgery is usually employed for many of these cases. However, we considered that a more minimal invasive therapy was necessary for patients who were inoperable due to low cardio-pulmonary function, other complications, severe adhesion and advanced age. Several investigators have applied various types of CT guided percutaneous modalities including percutaneous microwave coagulation therapy (PMCT), radiofrequency ablation (RFA), cryotherapy and photodynamic therapy (PDT) for small peripheral lung tumors experimentally and clinically and examined the possibility of these modalities for small lung tumors in inoperable patients. We reviewed their efficacy and safety. These percutaneous therapies demonstrate that good local control rate of 70-80%. However, recurrence from the tumor margin was of a problem. Pneumothrax occurred in 33.3-53.8% which is a main complication.
CT guided percutaneous therapies are considered to be a useful modality as a minimally invasive therapy for peripheral lung tumors with the intent of palliative or curative treatments. The results demonstrated the possibility of percutaneous modalities for the patients with small peripheral lung tumors in near future.
