RF ablation eligibility
criteria include biopsy-proven alignancy, radiographically
visible lesion, and three or fewer lesions with no lesion
larger than 6cm. Uncorrectable coagulopathy is an exclusion
Patients with primary nonresectable lung cancer (poor pulmonary
function, marginal cardiac function, extension into other
Patients with multiple tumors.
Tumors adjacent the chest wall would more safely be ablated
during a state of partial collapse of the lung to create
a safety barrier or zone to minimize injury to the neurovascular
bundle in the chest wall or other nearby vital structures
such as esophagus.
Nearby pulmonary vessel or bronchus to the tumor. Tumors
located near vital structures such as heart, esophagus, diaphragm,
etc. unless mobilization of the tumor containing lobe of
the lung away from the vital structure affording a “safety
zone” for RF ablation to occur. For example, in a lower
lobe tumor, it would be beneficial to deflate the lung then
mobilized the inferior pulmonary ligament endoscopically
and retract this lobe away from the diaphragm to then allow
safe administration of RF energy to the tumor during ventilation
since the 3D geometry of the proximity of the diaphragm and
other vital structures to the lower lobe change drastically
Video - What Are RFA's Advantages? by Dr. Nielson
• Treatment of multiple tumor types
in various locations that are unable to be successfully treated
• Multiple lung lesions can be treated without destroying
or resecting too much healthy lung tissue.
• Multiple tumors in both lungs can be treated successfully.
• Can be performed multiple times on different occasions.
• Recurrence of tumors can be easily treated.
• RFA of the lung is an emerging treatment.
a. Liver tumors has
b. RFA of Metastatic bone disease has been shown to significantly
reduce pain from the lesions
• Improved survival
might be possible.
• Patients with Metastatic disease can be treated with
RFA while the primary tumor could be treated with surgical
resection (ie: Breast cancer metastasized to the lung(s) Mastectomy
and RFA of lung metastases).
• RFA is not intended to replace surgery and/or chemotherapy,
but rather to be used in conjuction.
a. Chemotherapy causes
tumors to be more sensitive to RFA.
b. Debulking can be achieved using RFA allowing chemotherapy
to be more effective on remaining tumor cells.
• Provides a treatment
option where few existed given all patients with nonresectable
primary lung or metastatic cancer to the lung.
• Associated with lower morbidity and mortality compared
to other treatment options for patients with nonresectable
• Precise delivery of high energy to the tumor with less
adjacent tissue injury or tissue loss.
• Multi-modalities (i.e. percutaneous, thoracoscopic,
or open surgical)
*Data on file, Boston Scientific Corporation
• 10-15% chance of pneumothorax
(air leak from the lung, collapsed lung)
• 5% chance of bleeding (hemoptysis, hemorrhage into
lung tissue, or around lung)
• 2-5% chance of infection.