Skip to main content
The Egyptian Journal of Bronchology
Download PDF
  • Interventional Bronchology and pulmonology
  • Open access
  • Published:

A pilot study of chemical ablation of peripheral non-small-cell lung cancer: a novel, effective, safe, and inexpensive method

Egyptian Journal of Bronchology volume 10, pages 5–11 (2016)Cite this article

Abstract

Introduction

Chemical ablation with acetic acid or ethanol is effective against hepatocellular carcinoma and therefore its application in peripheral non-small-cell lung cancer (NSCLC) may be beneficial.

Aim

The aim of the study was to assess the efficacy and safety of percutaneous chemical ablation using acetic acid or ethanol in peripheral NSCLC cases.

Patients and methods

This was a prospective randomized control study conducted at the Chest and Clinical Oncology Departments, Mansoura, Egypt, from 2011 to 2014. Thirty-three patients were included with a mean age of 60 years, and were randomly divided into three groups: group A (acetic acid plus chemotherapy group) consisted of nine patients; group B (ethanol plus chemotherapy group) consisted of nine patients; and the control group C (chemotherapy alone group) consisted of 15 patients. Patients who were operable, who had tumors infiltrating the main stem bronchi or mediastinum, and those who refused to complete the study were excluded. Clinical and radiological data were evaluated before treatment and 3 and 6 months after treatment.

Results

There was a significant reduction in both cough score and chest pain in group A after 6 months of treatment, in the hemoptysis score in group A and group B after 6 months of treatment, and in dyspnea score in groups A and B after 3 and 6 months of treatment. There was a statistically significant difference in the tumor response results in both groups after 3 and 6 months of treatment when compared with the control group. There were one or more immediate complications but all were controllable with no mortality. Survival was better in groups A and B than in the control group. The cost of acetic acid and ethanol palliation for each patient was 10 $US.

Conclusion

Chemical ablation is an effective and inexpensive adjuvant palliative treatment for patients with inoperable peripheral NSCLC.

References

  1. Massion PP, Carbone DP. Biology of non-small cell lung cancer. In:. By, Mason RJ, Murray JF, Broaddus VC, Nadel JA, Martin RT, King TE, Talmadge E, Schraufnagel DE, editors. Murray and Nadel’s textbook of respiratory medicine. 5th ed. USA: Elsevier; 2010. 571–582.

    Google Scholar 

  2. Jantz MA, Silvestri GA. Fire and ice: laser bronchoscopy, electrocautery and cryotherapy. In Thoracic Endoscopy: Advances in Interventional Pulmonology. Simoff MJ, Sterman DH and Ernst A (eds.). Blackwell Publishing London; 2006. 1. 134–154.

    Google Scholar 

  3. Dupuy DE, DiPetrillo T, Gandhi S, et al. Radiofrequency ablation followed by conventional radiotherapy for medically inoperable stage I non-small cell lung cancer. Chest 2006; 129:738–745.

    Article  Google Scholar 

  4. Dupuy DE, Mayo-Smith WW, Abbott GF, et al. Clinical applications of radio-frequency tumor ablation in the thorax. RSNA 2002; 22:S259–S269.

    Google Scholar 

  5. Clark TW. Chemical ablation of liver cancer. Tech Vasc Interventional Rad 2007; 10:58–63.

    Article  Google Scholar 

  6. Huang JH, Fan WJ, Ready N, et al. CT-guided percutaneous ethanol ablation in the treatment of malignancies with pleural or chest wall invasion. Zhonghua Yi Xue Za Zhi 2008; 88:3365–3368.

    PubMed  Google Scholar 

  7. Ohnishi K, Yoshioka H, Ito S, et al. Prospective randomized controlled trial comparing percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma. Hepatology 1998; 27:67–72.

    Article  CAS  Google Scholar 

  8. Belfiore G, Moggio G, Tedeschi E, et al. CT-guided radiofrequency ablation: a potential complementary therapy for patients with unresectable primary lung cancer — a preliminary report of 33 patients. AJR 2004; 183:1003–1011.

    Article  Google Scholar 

  9. VanKralingen KW, vanKralingen-Heijboer AC, Zimmerman M, et al. Management of haemoptysis in a third city hospital a retrospective study. Tuber Lung dis 1995; 76:344B.

    Article  Google Scholar 

  10. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest 1988; 93:580–586.

    Article  CAS  Google Scholar 

  11. Melzack R. The short-form McGill Pain Questionnaire. Pain 1987; 30:191–197.

    Article  CAS  Google Scholar 

  12. Muers MF. Quality of life and symptom control. Eur Respir Monograph 2001; 17:305–329.

    Google Scholar 

  13. Fernando HC, De Hoyos A, Landreneau RJ, et al. Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates. J Thorac Cardiovasc Surg 2005; 129:639–644.

    Article  Google Scholar 

  14. Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, et al. International Association for the Study of Lung Cancer International Staging Committee. Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2007; 2:706–714.

    Article  Google Scholar 

  15. Shiina S, Tagawa K, Niwa Y, et al. Percutaneous ethanol injection therapy for hepatocellular carcinoma in 146 patients. Am J Roentgenol 1993; 160:1023–1028.

    Article  CAS  Google Scholar 

  16. David S, Kwan N, John B, et al. Hepatic tumor ablation. Surg Clin 2010; 90:863–876.

    Article  Google Scholar 

  17. Cardenal F, Lopez-Cabrerizo MP, Anton A, et al. Randomized phase III study of gemcitabine–cisplatin versus etoposide–cisplatin in the treatment of locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 1999; 17:12–18.

    Article  CAS  Google Scholar 

  18. Ohnishi K, Yoshioka H, Ito S, et al. Treatment of nodular hepatocellular carcinoma larger than 3 cm with ultrasound-guided percutaneous acetic acid injection. Hepatology 1996; 24:1379–1385.

    Article  CAS  Google Scholar 

  19. Huo TI, Huang YH, Wu JC, et al. Sequential transarterial chemoembolization and percutaneous acetic acid injection therapy versus repeated percutaneous acetic acid injection for unresectable hepatocellular carcinoma: a prospective study. Ann Oncol 2003; 14:1648–1653.

    Article  Google Scholar 

  20. Bloomston M, Binitie O, Fraiji E, et al. Transcatheter arterial chemoembolization with or without radiofrequency ablation in the management of patients with advanced hepatic malignancy. Am Surg 2002; 68:827–831.

    PubMed  Google Scholar 

  21. EL-Badrawy MKh, Elbadrawy A, Zeidan A, et al. Radiofrequency ablation in palliative treatment of nonoperable peripheral non small cell lung cancer. Egypt J Chest Dis Tuberculosis 2011; 60:30–37.

    Google Scholar 

  22. Lee JM, Jin GY, Goldberg SN, et al. Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology 2004; 230:125–134.

    Article  Google Scholar 

  23. Bojarski JD, Dupuy DE, Mayo-Smith WCT. Imaging Findings of pulmonary neoplasms after treatment with radiofrequency ablation: results in 32 tumors. AJR 2005; 185:466–471.

    Article  Google Scholar 

  24. Yang-Kui G, Wei-Jun F, Huang J, et al. Efficacy of CT-guided intra-tumoral dehydrated ethanol injection on lung metastasis from liver cancer. Chin J Cancer 2007; 26:31.

    Google Scholar 

  25. Masaki Y, Yamamoto M, Nishimura H, et al. Ethanol injection therapy to the lung cancer. Kyobu Geka. 1997; 50:384–388.

    PubMed  CAS  Google Scholar 

  26. Zhu JC, Yan TD, Glenn D, et al. Radiofrequency ablation of lung tumors: feasibility and safety. Ann. Thorac. Surg 2009; 87:1028–1029.

    Article  Google Scholar 

  27. Ambrogi MC, Lucchi M, Dini P, et al. Percutaneous radiofrequency ablation of lung tumours: results in the mid-term. European Journal of Cardio-thoracic Surgery 2006; 30: 177–183.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Chest Medicine, Mansoura University, 15-Beshbeshi St, Hay Elgamaa, Mansoura, Egypt

    Mohammad K. El Badrawy, Ahmad Y. Badawy, Asem A. Hewidy & Mohammad M. El Gamal

  2. Departments of Clinical Oncology and Nuclear Medicine, Mansoura University, Mansoura, Egypt

    Saleh M. Ta-Ema

Authors
  1. Mohammad K. El Badrawy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmad Y. Badawy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Saleh M. Ta-Ema
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Asem A. Hewidy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohammad M. El Gamal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Asem A. Hewidy.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El Badrawy, M.K., Badawy, A.Y., Ta-Ema, S.M. et al. A pilot study of chemical ablation of peripheral non-small-cell lung cancer: a novel, effective, safe, and inexpensive method. Egypt J Bronchol 10, 5–11 (2016). https://doi.org/10.4103/1687-8426.176659

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1687-8426.176659

Keywords