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Long Term Efficacy of Radio Frequency Ablation for Superficial Lesions of the Tracheobronchial Tree
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A3182 - Long Term Efficacy of Radio Frequency Ablation for Superficial Lesions of the Tracheobronchial Tree
Author Block: C. Steppert; Pulmonology, thoracic oncology and sleep medicine, VI. Med. Klinik, Bayreuth, Germany.
Introduction: Superficial tumors of the tracheobronchial tree are mostly treated by thermal ablation by argon- plasma coagulation, LASER or cryotherapy. Advantages of these techniques are that they are widely available but the extension of the energy delivered can not be controlled. In Barrett's disease of the esophagus radio frequency ablation (RFA) is an established technique for the treatment of this superficial tumor. Case: 2011 a 74 year old male patient with a verrucous carcinoma of the trachea was admitted to our hospital. As the patient was 77 years with an additional diagnosis of severe stenosis of the aortic valve that had been treated by transfemoral valve replacement, he was deemed unsuitable for a resection of the distal trachea with end- to- end anastomosis. After treating the intraluminal lesion with Nd- YAG- LASER and cryotherapy the patient was recurrence- free until October 2014. After local recurrence photodynamic LASER therapy was applied without success. To apply a well- defined amount of energy with well- defined invasion depth, radiofrequency ablation via a planar applicator (BARRX, Covidien, Sunnyvale, CA ) was chosen and the patient informed, that this technique has not been used in the bronchial tree so far. After written consent 45 applications with an energy of 12W/cm2 were given to the posterior membrane during rigid bronchoscopy. Conversely to the photodynamic therapy the treatment was initially successful. There were no acute or delayed side effects of the treatment. Today, 30 months after the treatment there is no evidence of recurrence of the tumor. There is only a hardly visible scar at the posterior membrane of the trachea. Conclusion: in superficial tumors of the tracheobronchial tree RFA is a viable alternative to other thermal ablation techniques. The use of planar or circumferential applicators warrants a defined area of application with a controllable invasion depth.
Author Block: C. Steppert; Pulmonology, thoracic oncology and sleep medicine, VI. Med. Klinik, Bayreuth, Germany.
Introduction: Superficial tumors of the tracheobronchial tree are mostly treated by thermal ablation by argon- plasma coagulation, LASER or cryotherapy. Advantages of these techniques are that they are widely available but the extension of the energy delivered can not be controlled. In Barrett's disease of the esophagus radio frequency ablation (RFA) is an established technique for the treatment of this superficial tumor. Case: 2011 a 74 year old male patient with a verrucous carcinoma of the trachea was admitted to our hospital. As the patient was 77 years with an additional diagnosis of severe stenosis of the aortic valve that had been treated by transfemoral valve replacement, he was deemed unsuitable for a resection of the distal trachea with end- to- end anastomosis. After treating the intraluminal lesion with Nd- YAG- LASER and cryotherapy the patient was recurrence- free until October 2014. After local recurrence photodynamic LASER therapy was applied without success. To apply a well- defined amount of energy with well- defined invasion depth, radiofrequency ablation via a planar applicator (BARRX, Covidien, Sunnyvale, CA ) was chosen and the patient informed, that this technique has not been used in the bronchial tree so far. After written consent 45 applications with an energy of 12W/cm2 were given to the posterior membrane during rigid bronchoscopy. Conversely to the photodynamic therapy the treatment was initially successful. There were no acute or delayed side effects of the treatment. Today, 30 months after the treatment there is no evidence of recurrence of the tumor. There is only a hardly visible scar at the posterior membrane of the trachea. Conclusion: in superficial tumors of the tracheobronchial tree RFA is a viable alternative to other thermal ablation techniques. The use of planar or circumferential applicators warrants a defined area of application with a controllable invasion depth.
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