Ablation may be effective in battling small-cell lung cancer

Researchers from Brown University touted the efficacy of tumor ablation in treating small-cell lung cancer, publishing their results in the Journal of Vascular and Interventional Radiology.

Ablation has become an increasingly important tool in interventional oncology—it’s minimally invasive, precise and cheaper than conventional surgery. However, its role in the fight against lung cancer has been limited to early-stage adenocarcinoma, or non-small cell lung cancer.

The slow growth of non-small cell lung cancer, the most common type of lung cancer, lends well to treatment—especially ablation. Conversely, it is the most aggressive form of lung cancer, with a propensity to develop resistance to chemotherapy. While a multi-drug regimen has been the treatment paradigm for years, recent studies have reopened the case for surgery. 

Many lung cancer patients aren’t healthy enough to undergo a major surgical procedure, according to lead author Aaron Maxwell, MD, diagnostic radiology resident at the Warren Alpert Medical School of Brown University. Most have significant co-morbidities, including chronic obstructive pulmonary disease (COPD) or other smoking-related illnesses.

In spite of these conditions, many are healthy enough for ablation.  

Maxwell hypothesized that their outcomes would improve—partly based on the 92 percent two-year survival rate for non-small cell patients treated with ablation—and conducted a retrospective review. While the sample size was limited (only nine patients), the results suggest that ablation is effective in treating small-cell lung cancer.

The median overall survival was 16 months, but there was a stark difference between patients with localized versus disseminated cancer.

Patients with local disease had a median survival of 47 months, compared to just 5.5 months for those with disseminated disease. This falls in line with published literature, according to Maxwell.

“Patients with disseminated small cell lung cancer have a very poor prognosis regardless of what treatment they receive,” he said. “The different in outcomes is thus a function of the disease rather than the treatment, though our results suggest there may be a role for thermal ablation in the population with or without other treatments such as chemotherapy or radiation.”

It’s important to note that patients with local cancer didn’t receive any other type of treatment. Ablation was the sole mode of therapy.

Maxwell personally testified to the effectiveness of ablation, saying Brown sees multiple patients a week for ablation consults, although such practice may not be realistic for all hospitals.

“In certain areas, ablation may be harder to access as a patient,” he said. “However, it’s shorter to preform and it costs much less than surgery, making it overall a more cost-effective cancer treatment for certain cancers."