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Background
Curative resection is the standard treatment for primary (stage I–IIIa) non-small cell lung cancer (NSCLC). However, some cases diagnosed as "early-stage" cancer before surgery are actually found to be pleural disseminated NSCLC during the operation. For patients with such cases, surgical resection is not the treatment of choice. However, the prognosis would remain poor even if the patient undergoes chemotherapy or radiotherapy instead, with a survival rate close to stage IIIa–IIIb cancer, as reported by Sawabata and colleagues. Traditionally, talc pleurodesis (TP) is performed for the control of pleural effusions associated with pleural disseminated NSCLCs. Although TP has been shown to be safe and effective, the prognoses of patients who undergo TP remain unchanged. Hence, new treatment strategies are required to improve the survival of patients with advanced-stage NSCLC.
Since first reported by Dupuy and colleagues, radiofrequency ablation (RFA) has been considered an alternative treatment of lung cancer and shown to obtain remarkable outcomes especially in patients with early-stage cancer who could not tolerate standard surgery. In the current literature, the reported complete remission (CR) rate, as well as the median survival time from NSCLC patients underwent RFA were promising. However, as for advanced lung cancers, whether RFA could obtain the same remarkable outcomes as it did for early-stage lesions remains unclear.
In this study, we hypothesized that RFA is beneficial to patients with pleural disseminated NSCLC. Therefore, we compared alternative (RFA combined with TP [R-TP]) and conservative therapies (TP alone) to determine whether R-TP would be technically safe and oncologically beneficial in the treatment of advance NSCLCs.
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