Pediatric Applications of Radiofrequency Ablation

ABSTRACT

Radiofrequency (RF) ablation is an established practice for the treatment of pediatric osteoid osteoma, and for the ablation of the accessory conduction pathways that cause cardiac arrhythmia in children. The RF tumor ablation literature is mushrooming with studies that apply to adults, but it is non-existent in pediatric oncology. However, a percutaneously placed radiofrequency probe can ablate the primary and metastatic tumors of the liver, lung, bone, soft tissue, kidney, and other structures in children. This is an alternative treatment for the local control of tumors that may not be amenable to surgery, chemotherapy, or radiotherapy. RF ablation has advantages over surgery by potentially causing less tissue loss. This is especially true for lesions that are deeply seated. Chemotherapy is limited by regional vascular access and high interstitial pressures in the tumor, which can make diffusion of the chemotherapy to parts of the mass difficult or impossible. Radiotherapy is impacted by the oxygenation of the tumor; areas of the tumor that are hypoxic do not respond as favorably to radiotherapy. RF ablation and other thermal ablation techniques can overcome the problems of these other local control techniques and potentially can completely ablate the tumor.

KEYWORDS

Radiofrequency (RF) ablation - interventional procedures - osteoid osteoma - neoplasms - therapy

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