Radiofrequency, chemotherapy prove effective duo in destroying tumors

June 19, 2003

NEW YORK - Radiofrequency ablation (RFA) combined with chemotherapy is currently being used to treat malignant liver tumors at a Boston hospital on the basis of results from a new study appearing in the July issue of the journal Radiology.

The minimally invasive, outpatient procedure is performed on primary liver cancer or colon cancer tumors that have spread to the liver of patients at Beth Israel Deaconess Medical Center.

"It's exciting that a simple, image-guided technique, along with chemotherapy, can enhance the area of tumor killed," said Jonathan B. Kruskal, M.D., Ph.D., section chief of abdominal imaging at Beth Israel Deaconess and associate professor of radiology at Harvard Medical School in Boston. "Our research shows that we are now able to treat larger tumors with this combined therapy."

RFA uses heat to destroy malignant tumors. After sedating the patient, radiologists locate the tumor with computed tomography (CT) or magnetic resonance (MR) imaging. A four- to 10-inch-long electrode, similar to a biopsy needle, is guided into the center of a tumor via imaging.

The electrode delivers radiofrequency current to heat and destroy the tumor tissue.

Dr. Kruskal co-authored the Radiology study, which indicated that with the addition of chemotherapy, tumors larger than five centimeters can be treated with RFA and that partially destroying tumors with RFA slows tumor growth and improves survival.

"Large tumors are typically not considered amenable to RFA treatment. Our results suggest that they may well be," he said.

The research, performed by Guiseppe D'Ippolito, M.D., and colleagues under the direction of S. Nahum Goldberg, M.D., the senior author of the study, was the first randomized controlled study on combined RFA and chemotherapy treatments in animals. Dr. Kruskal presented it today during a Radiological Society of North America (RSNA) media briefing on image-guided therapies.

Liposomal doxorubicin (a chemotherapeutic agent) and RFA were used to treat breast tumors implanted into 49 rats and grown from 10 days to two weeks. The animals were divided into four treatment groups: RFA only, doxorubicin only, RFA combined with doxorubicin, and a control group receiving no treatment.

Doxorubicin is dispensed in fat droplets, which circulate through the body and find the tumor, helping to destroy it. When doxorubicin was combined with RFA, results showed a reduction in tumor growth rates and a tripling in the average survival rate compared with the group receiving no treatment.

"The survival of animals increased from nine days in the control group to 27 days with the combined therapy," Dr. Kruskal said. "This study opens up the possibilities of using other drug cocktails with RFA to kill tumors and to treat tumors outside of the liver." RFA is a good option for treating liver tumors. Many people with liver tumors are not appropriate candidates for surgery because their tumors are too widespread or inaccessible or because of their poor physical health. They also may not be candidates for a liver transplant.

A liver tumor can be ablated with radiofrequency in about 30 to 60 minutes, without affecting the liver's normal tissue. RFA is a one- to three-hour outpatient procedure that can be used to treat recurrent liver tumors. It is less risky than surgery, can be performed without general anesthesia and causes minimal discomfort. Patients can most often go home the same day.

Risks associated with RFA include bleeding and injury to other organs and "post-ablation" syndrome, which includes flu-like symptoms.

Beth Israel Deaconess is currently the only hospital providing combined RFA and liposomal chemotherapy, according to Dr. Kruskal. Approximately 25 patients have been treated with the combined therapy by Dr. Goldberg, director of the tumor ablation program at Beth Israel Deaconess, and they are seeing a 25 percent increase in the volume of tumor destruction. Based on these results, Drs. Goldberg and Kruskal are planning further studies, including a large clinical study comparing RFA alone to RFA combined with liposomal chemotherapy.

"RFA has been used worldwide for the last five or six years to treat tumors up to five centimeters," Dr. Kruskal said. "With the new combined therapy, where patients are given doxorubicin intravenously prior to the start of RFA, physicians will be able to treat larger tumors, up to eight centimeters."

The purpose of this study, partly funded by the National Cancer Institute and the National Institutes of Health, was to determine whether combined intravenous liposomal doxorubicin and RFA decreased tumor growth and increased endpoint survival - that is, from the start of treatment until the tumor reached three centimeters.

Following treatment, tumors were measured every two to three days until they reached three centimeters. The rats that received RFA and doxorubicin had a mean endpoint survival of 27 days. Rats receiving either RFA or injections of doxorubicin had an endpoint survival of 16 days. The control group, with no treatment, reached endpoint survival at 10 days.
-end-
Radiology is a monthly scientific journal devoted to clinical radiology and allied sciences. The journal is edited by Anthony V. Proto, M.D., School of Medicine, Virginia Commonwealth University, Richmond, Va. Radiology is owned and published by the Radiological Society of North America Inc. http://radiology.rsnajnls.org

The RSNA is an association of more than 33,000 radiologists, radiation oncologists and related scientists committed to promoting excellence through education and by fostering research, with the ultimate goal of improving patient care. The Society's headquarters are located at 820 Jorie Blvd., Oak Brook, Ill. 60523-2251. http://www.rsna.org

For information on radiology procedures and therapies, visit http://www.RadiologyInfo.org.

"Percutaneous Tumor Ablation: Reduced Tumor Growth with Combined Radio-Frequency Ablation and Liposomal Doxorubicin in a Rat Breast Tumor Model." Collaborating with Dr. Kruskal on this study were Nahum Goldberg, M.D.; Giuseppe D'Ippolito, M.D.; Muneeb Ahmed, M.D.; Geoffrey D. Girnun, Ph.D.; Keith E. Stuart, M.D.; and Elkan F. Halpern, Ph.D.

Radiological Society of North America

Related Chemotherapy Articles from Brightsurf:

Chemotherapy is used to treat less than 25% of people with localized sarcoma
UCLA researchers have found that chemotherapy is not commonly used when treating adults with localized sarcoma, a rare type of cancer of the soft tissues or bone.

Starved cancer cells became more sensitive to chemotherapy
By preventing sugar uptake, researchers succeeded in increasing the cancer cells' sensitivity to chemotherapeutic treatment.

Vitamin D could help mitigate chemotherapy side effects
New findings by University of South Australia researchers reveal that Vitamin D could potentially mitigate chemotherapy-induced gastrointestinal mucositis and provide relief to cancer patients.

Less chemotherapy may have more benefit in rectal cancer
GI Cancers Symposium: Colorado study of 48 patients with locally advanced rectal cancer receiving neoadjuvant chemotherapy, found that patients receiving lower-than-recommended doses in fact saw their tumors shrink more than patients receiving the full dose.

Male fertility after chemotherapy: New questions raised
Professor Delb├Ęs, who specializes in reproductive toxicology, conducted a pilot study in collaboration with oncologists and fertility specialists from the McGill University Health Centre (MUHC) on a cohort of 13 patients, all survivors of pediatric leukemia and lymphoma.

'Combo' nanoplatforms for chemotherapy
In a paper to be published in the forthcoming issue in NANO, researchers from Harbin Institute of Technology, China have systematically discussed the recent progresses, current challenges and future perspectives of smart graphene-based nanoplatforms for synergistic tumor therapy and bio-imaging.

Nanotechnology improves chemotherapy delivery
Michigan State University scientists have invented a new way to monitor chemotherapy concentrations, which is more effective in keeping patients' treatments within the crucial therapeutic window.

Novel anti-cancer nanomedicine for efficient chemotherapy
Researchers have developed a new anti-cancer nanomedicine for targeted cancer chemotherapy.

Ending needless chemotherapy for breast cancer
A diagnostic test developed at The University of Queensland might soon determine if a breast cancer patient requires chemotherapy or would receive no benefit from this gruelling treatment.

A homing beacon for chemotherapy drugs
Killing tumor cells while sparing their normal counterparts is a central challenge of cancer chemotherapy.

Read More: Chemotherapy News and Chemotherapy Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.