癌症进展2024,Vol.22Issue(3) :318-322,343.DOI:10.11877/j.issn.1672-1535.2024.22.03.20

微波消融与射频消融治疗中小肝脏恶性肿瘤临床疗效的Meta分析

Meta-analysis of the clinical efficacy of microwave ablation and radiofrequency ablation in the treatment of small and medium-sized liver malignant tumors

苗苗 王海静 贾巴见明 陈强 罗琳 原小军
癌症进展2024,Vol.22Issue(3) :318-322,343.DOI:10.11877/j.issn.1672-1535.2024.22.03.20

微波消融与射频消融治疗中小肝脏恶性肿瘤临床疗效的Meta分析

Meta-analysis of the clinical efficacy of microwave ablation and radiofrequency ablation in the treatment of small and medium-sized liver malignant tumors

苗苗 1王海静 1贾巴见明 1陈强 2罗琳 2原小军2
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作者信息

  • 1. 内蒙古科技大学包头医学院研究生院,内蒙古 包头 014010
  • 2. 内蒙古科技大学包头医学院第一附属医院医学影像科,内蒙古 包头 014010
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摘要

目的 通过Meta分析比较射频消融(RFA)及微波消融(MWA)治疗中小肝脏恶性肿瘤的疗效及安全性.方法 检索2012年1月至2022年1月在中英文主要数据库发表的关于MWA及RFA治疗中小肝脏恶性肿瘤的随机对照试验(RCT).对比MWA及RFA治疗肝脏恶性肿瘤的完全消融率(CA)、主要并发症发生率、无复发生存率(RFS)、总生存率(OS)、局部复发率(LTP)、肝内远处转移率(IDR)、消融时间和手术时间.采用STA-TA15.0软件进行统计分析并绘制森林图.结果 共纳入10项RCT,进行MWA及RFA治疗的患者分别为468、517例.RFA组及MWA组的CA分别为91.8%、93.1%,两组比较,差异无统计学意义[优势比(OR)=0.87,95%CI:0.53~1.42,P>0.05].RFA组平均消融时间为17.3 min,MWA组平均消融时间为11.1 min,MWA组平均消融时间短于RFA组[加权均数差(WMD)=6.47,95%CI:4.40~8.54,P<0.05].两组患者其余次要结局指标如OS、LTP、IDR、手术时间、主要并发症发生率和1年RFS比较,差异均无统计学意义(P>0.05).结论 对于<5cm的肝脏恶性肿瘤,MWA与RFA治疗效果相似,MWA仅在消融时间方面存在优势.

Abstract

Objective To compare the efficacy and safety of radiofrequency ablation(RFA)and microwave ablation(MWA)in the treatment of small and medium-sized liver malignant tumors by Meta-analysis.Method Major Chinese and English databases were used to search the published randomized controlled trial(RCT)comparing MWA and RFA in the treatment of small and medium-sized liver malignant tumors from January 2012 to January 2022.The complete abla-tion rate(CA),incidence of major complications,recurrence free survival(RFS),overall survival(OS),local tumor pro-gression rate(LTP),intrahepatic distant recurrence(IDR),ablation time and operation time were compared between MWA and RFA in the treatment of liver malignant tumors.STATA15.0 software was used for statistical analysis and for-est mapping.Result A total of 10 RCT were included,and 468 and 517 patients were treated with MWA and RFA,re-spectively.The CA of the RFA group and the MWA group were 91.8%and 93.1%,respectively,there was no signifi-cant difference between the two groups[odds ratio(OR)=0.87,95%CI:0.53-1.42,P>0.05].The mean ablation time was 17.3 min in RFA group and 11.1 min in MWA group,respectively,the difference was statistically significant[weighted mean difference(WMD)=6.47,95%CI:4.40-8.54,P<0.05].There were no significant differences in OS,LTP,IDR,opera-tion time,incidence of major complications,and 1-year RFS between the two groups(P>0.05).Conclusion For liver ma-lignant tumors less than 5 cm,MWA and RFA have similar efficacy.MWA is superior only in ablation time.

关键词

微波消融/射频消融/肝脏恶性肿瘤/Meta分析

Key words

microwave ablation/radiofrequency ablation/liver malignant tumor/Meta-analysis

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出版年

2024
癌症进展
中国医学科学院,北京协和医学院

癌症进展

影响因子:1.004
ISSN:1672-1535
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