In Reply: Radiofrequency Ablation (RFA) of Pulmonary Metastases: Technical Success vs. Actual Benefit

Excerpt

Thank you for your letter. I would like to address your questions in regard to the rationale in treating these so-called “palliative” patients with RFA. We have labeled three patients as “palliative” because of either evidence of coexisting bony metastases or the extent of pulmonary disease as in the patient with 17 pulmonary metastases. I would agree that the treatment of only some of the metastases would not provide any survival benefit. However, RFA was not the only treatment modality in this group of patients, but was used as an adjunct to their treatment. In addition to their RFAs, these patients had received a combination of systemic therapies in the form of interferon, 5-FU, and interleukin-2. They also had further resections of metastases in the brain or lung and radiotherapy to bony disease. Despite the combination of these various forms of treatments, we felt that we were unlikely to provide a cure for these patients, but instead we hoped to provide some survival benefit with a multimodality approach to these young patients. Thus, RFA under these circumstances could not be considered potentially curative. …