Hot Saline Thermoablation of Peripheral Non Small Cell Lung Cancer safety and Efficacy: a Pilot Study

Hot saline thermoablation is effective and safe for hepatoma so its application to peripheral non-small cell lung cancer NSCLC may be beneficial. Aim: Assess the efficacy and safety of palliative transthoracic hot isotonic saline injection of peripheral inoperable NSCLC Patients and Methods: Randomized clinical trial done at Chest, Clinical Oncology departments and Oncology Center Mansoura, Egypt, 2013 to 2015. 23 patients with peripheral NSCLC randomly divided to 2 groups: group A, 11 patients subjected to transthoracic hot isotonic saline injection and group B, 12 patients subjected to transthoracic injection of isotonic saline at room temperature (immediately both groups were treated with chemotherapy). Primary endpoints were clinical, functional and radiological response and tumor tissue histopathology posttreatment. Secondary endpoint was survival. Results: Significant decrease in chest pain and dyspnea in group A versus group B, 3 and 6 months posttreatment. Hot saline braked deterioration in quality of life. After 6 months, there was statistically significant increase in FEV1 and FVC in group A versus before treatment. 8 patients in group A had partial response 72.7% and 3 patients had progression 27.3% and 7 patients in group B had stable course 58.3% and 5 patients had progression 41.7% after 6 months. 10 patients in group A had coagulative necrosis while 6 patients from group B had ischemic necrosis. There were few immediate controllable complications. Survival was better in group A than group B but statistically insignificant. Conclusion: Hot saline thermoablation is effective, safe palliative treatment for patients with inoperable peripheral NSCLC. PACTR201601001384408.