Phase II kidney cancer trial demonstrates efficacy
CLEVELAND: Preliminary results from a Phase II study presented last week at the Radiological Society of North America meeting in Chicago demonstrate the effectiveness of non-surgical radiologic intervention using heat in the treatment of kidney cancers. Under MRI-guidance, which facilitates the placement of the probe and assures the complete destruction of the tumor mass, Dr. Jonathan Lewin has successfully "ablated" tumors in six patients, who have since had no recurrence of their disease.
Dr. Lewin has extensive experience through Phase I and now Phase II trials using radiofrequency ablation to heat tumors to a boiling point, using a needle that is directed into the tumor under magnetic resonance imaging (MRI) guidance. This procedure is done in a non-surgical setting, and the kidney cancer patients treated have all been poor surgical candidates (either because of age or other health issues). In this kind of cancer, you would normally see a recurrence within three to six months--but all of the patients being reported on are beyond that time period with no recurrence. Treatment was successful after only one session with RF ablation (the MRI guidance makes it possible to "see" the edges of the disease and destroy the entire tumor--temperature and tissue coagulation is visualized under MRI, achieving greater accuracy than ultrasound or CT imaging).
According to Dr.Lewin, the preliminary analysis shows that for small tumors (3 cm. or less), this approach is likely to result in the complete eradication of the cancer and the procedure is well-tolerated by patients. No patient has had to take more than Tylenol for post-procedure pain. Dr. Lewin is one of the nation’s leading experts in interventional radiology, and has helped develop some of the tools required for use with magnetic resonance imaging. For several years, he has combined radiofrequency ablation techniques with MRI to eradicate kidney tumors. Using open MRI, which provides more comfortable surroundings to patients, doctors gain access to these abnormalities through a needle puncture. Using specially-designed titanium or stainless steel instruments which are not magnetic, doctors are guided by the MRI image to the site of the malignancy. They guide a titanium electrode (developed by Radionics of Burlington, Mass.) to the tumor and generate enough heat (just below the boiling point) to destroy the cancer cells.
"What used to be a bright white area of tumor becomes black, essentially a black hole of dead tumor tissue," says Dr. Lewin. "You can immediately see through the MRI image how much of the tumor is destroyed, how much is left, and how much further you need to go to completely eradicate the cancer." There is also no cumulative dose effect, as there is in radiation therapy, so patients can be treated repeatedly if the cancer returns to other sites.
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