[1]潘 武,强 勇,阳圆圆.经皮微波消融与射频消融治疗肝癌的Meta分析[J].医学信息,2024,37(20):20-27.[doi:10.3969/j.issn.1006-1959.2024.20.003]
 PAN Wu,QIANG Yong,YANG Yuanyuan.Meta-analysis of Percutaneous Microwave Ablation and Radiofrequency Ablation in the Treatment of Liver Cancer[J].Journal of Medical Information,2024,37(20):20-27.[doi:10.3969/j.issn.1006-1959.2024.20.003]
点击复制

经皮微波消融与射频消融治疗肝癌的Meta分析()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年20期
页码:
20-27
栏目:
医学数据科学
出版日期:
2024-10-15

文章信息/Info

Title:
Meta-analysis of Percutaneous Microwave Ablation and Radiofrequency Ablation in the Treatment of Liver Cancer
文章编号:
1006-1959(2024)20-0020-08
作者:
潘 武1强 勇1阳圆圆2
荆门市人民医院肝胆胰外科1,甲乳外科2,湖北 荆门 448000
Author(s):
PAN Wu1QIANG Yong1YANG Yuanyuan2
Department of Hepatobiliary Surgery1,Department of Thyroid Breast Surgery2,Jingmen People’s Hospital,Jingmen 448000,Hubei,China
关键词:
微波消融射频消融完全消融率随机对照试验
Keywords:
Microwave ablationRadiofrequency ablationComplete ablation rateRandomized controlled trials
分类号:
R735.7
DOI:
10.3969/j.issn.1006-1959.2024.20.003
文献标志码:
A
摘要:
目的 比较微波消融和射频消融治疗肝癌的疗效。方法 计算机检索Pubmed 数据库、Embase数据库、Cochrane图书馆、知网和万方数据库所发表的关于微波消融对比射频消融治疗肝癌的随机对照试验(RCTs),检索时限为数据库建库之日至2022年6月。采用Stata 16.0和Review Manager 5.4软件进行Meta分析。结果 最终纳入12篇RCTs,总计1395例患者。两种消融方法完全消融率比较,差异无统计学意义(OR=1.41,95%CI:0.93~2.12,P=0.10);相较于射频消融,微波消融消融时间更短(MD=-10.18,95%CI:-14.52~-5.83,P<0.01));两种消融方法1年总体生存率(OR=1.55,95%CI:0.86~2.78,P=0.14)、3年总体生存率(OR=0.93,95%CI:0.62~1.38,P=0.71)、无复发生存率(OR=0.72,95%CI:0.48~1.08,P=0.11),主要不良事件(OR=1.99,95%CI:0.75~5.29,P=0.17)、肝局灶性坏死(OR=0.34,95%CI:0.03~3.29,P=0.35)、皮肤灼伤(OR=1.48,95%CI:0.41~5.40,P=0.55)、包膜下血肿(OR=0.42,95%CI:0.12~1.45,P=0.17)比较,差异无统计学意义。结论 在肝癌患者的治疗效果方面,两种消融方法无明显差异,微波消融消融时间更短。
Abstract:
Objective To compare the efficacy of microwave ablation and radiofrequency ablation in the treatment of liver cancer.Methods The randomized controlled trials (RCTs) on microwave ablation versus radiofrequency ablation for liver cancer published in Pubmed database, Embase database, Cochrane library, CNKI and Wanfang database were searched by computer from the date of database establishment to June 2022. Meta-analysis was performed using Stata 16.0 and Review Manager 5.4 software.Results A total of 12 RCTs involving 1395 patients were included. There was no significant difference in complete ablation rate between the two ablation methods (OR=1.41, 95%CI: 0.93-2.12, P=0.10). Compared with radiofrequency ablation, microwave ablation had shorter ablation time (MD=-10.18, 95%CI:-14.52 to -5.83, P<0.01). While there was no significant difference in 1-year overall survival rate (OR=1.55, 95%CI: 0.86-2.78, P=0.14), 3-year overall survival rate (OR=0.93, 95%CI: 0.62-1.38, P=0.71), and recurrence-free survival rate (OR=0.72, 95%CI: 0.48-1.08, P=0.11), major adverse events (OR=1.99, 95%CI: 0.75-5.29, P=0.17), focal liver necrosis (OR=0.34, 95%CI: 0.03-3.29, P=0.35), skin burns (OR=1.48, 95%CI: 0.41-5.40, P=0.55), and subcapsular hematoma (OR=0.42, 95%CI: 0.12-1.45, P=0.17) between the two ablation methods.Conclusion There is no significant difference between the two ablation methods in the treatment of patients with liver cancer, but the microwave ablation time is shorter.

参考文献/References:

[1]Yang JD,Roberts LR.Epidemiology and management of hepatocellular carcinoma[J].Infect Dis Clin North Am,2010,24(4):899-viii.[2]中华人民共和国国家卫生健康委员会医政医管局.原发性肝癌诊疗指南(2022年版)[J]. 中华消化外科杂志,2022,21(2):143-168.[3]Patel V,Ritchie CA,Padula C,et al.Radiofrequency Ablation,Where It Stands in Interventional Radiology Today[J].Semin Intervent Radiol,2019,36(5):398-404.[4]Poulou LS,Botsa E,Thanou I,et al.Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma[J].World J Hepatol,2015,7(8):1054-1063.[5]郭志远,付吕平,付志国,等.经皮射频消融术与微波消融治疗肝癌的治疗效果对比[J].实用癌症杂志,2015,30(9):1386-1388.[6]王敏,余文杰,侯文明.基于倾向评分分析微波消融与射频消融治疗肝细胞癌效果研究[J].浙江创伤外科,2022,27(2):317-319.[7]Kamal A,Elmoety AAA,Rostom YAM,et al.Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial[J].J Gastrointest Oncol,2019,10(3):562-571.[8]黄锦梅,刁宇红.经皮微波消融术治疗原发性肝癌的临床效果和安全性分析[J].中国医学前沿杂志(电子版),2019,11(9):159-162.[9]Vietti Violi N,Duran R,Guiu B,et al.Efficacy of microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma in patients with chronic liver disease: a randomised controlled phase 2 trial[J].Lancet Gastroenterol Hepatol,2018,3(5):317-325.[10]Moher D,Liberati A,Tetzlaff J,et al.Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement[J].PLoS Med,2009,6(7):e1000097.[11]Higgins JP,Green S.Cochrane Handbook for Systematic Reviews of Interventions [J].Naunyn-Schmiedebergs Archivfürexperimentelle Pathologie und Pharmakologie, 2008, 5(2):S38.[12]Guyatt GH,Oxman AD,Vist GE,et al.GRADE: an emerging consensus on rating quality of evidence and strength of recommendations[J].BMJ,2008,336(7650):924-926.[13]Brok J,Thorlund K,Wetterslev J,et al.Apparently conclusive meta-analyses may be inconclusive--Trial sequential analysis adjustment of random error risk due to repetitive testing of accumulating data in apparently conclusive neonatal meta-analyses[J].Int J Epidemiol,2009,38(1):287-298.[14]田文硕,匡铭,吕明德,等.超声引导经皮射频消融与微波消融治疗肝脏肿瘤的随机对照研究[J].中华肝胆外科杂志,2014,20(2):119-122.[15]王喜功,潘吉荣,张峰.超声引导下经皮射频消融与微波消融治疗原发性肝细胞癌的比较[J].中国医学影像学杂志,2015,23(8):606-609.[16]徐娟,赵晔,付晓丹,等.超声引导下经皮微波消融与射频消融治疗原发性肝癌的临床疗效对比分析[J].中国医学装备,2016,13(12):55-58,59.[17]古琼芳,周懂晶,李益红,等.超声引导下微波与射频消融治疗小肝癌的临床疗效比较[J].医学理论与实践,2010,23(6):683-684.[18]沈桢,阎皓.射频消融与微波消融治疗原发性小肝癌安全性、有效性及对免疫功能影响的对比研究[J].现代中西医结合杂志,2016,25(33):3659-3662.[19]Shibata T,Iimuro Y,Yamamoto Y,et al.Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy[J].Radiology,2002,223(2):331-337.[20]Abdelaziz A,Elbaz T,Shousha HI,et al.Efficacy and survival analysis of percutaneous radiofrequency versus microwave ablation for hepatocellular carcinoma: an Egyptian multidisciplinary clinic experience[J].Surg Endosc,2014,28(12):3429-3434.[21]Di Vece F,Tombesi P,Ermili F,et al.Coagulation areas produced by cool-tip radiofrequency ablation and microwave ablation using a device to decrease back-heating effects: a prospective pilot study[J].Cardiovasc Intervent Radiol,2014,37(3):723-729.[22]Yu J,Yu XL,Han ZY,et al.Percutaneous cooled-probe microwave versus radiofrequency ablation in early-stage hepatocellular carcinoma: a phase III randomised controlled trial[J].Gut,2017,66(6):1172-1173.[23]Ohmoto K,Yoshioka N,Tomiyama Y,et al.Comparison of therapeutic effects between radiofrequency ablation and percutaneous microwave coagulation therapy for small hepatocellular carcinomas[J].J Gastroenterol Hepatol,2009,24(2):223-227.[24]胡鹏,钱国军,孙爱学,等.微波和射频治疗高龄肝癌患者疗效和安全性比较[J].肝胆外科杂志,2012,20(5):348-352.[25]谢彩凤,柳伟,王宇.超声引导下微波消融治疗小细胞肝癌的效果及对免疫功能的影响[J].中国医学工程,2020,28(2):97-99.[26]Suwa K,Seki T,Aoi K,et al.Efficacy of microwave ablation versus radiofrequency ablation for hepatocellular carcinoma: a propensity score analysis[J].Abdom Radiol (NY),2021,46(8):3790-3797.[27]Mahnken AH.Leitliniengerechte Anwendung der Thermoablation beim hepatozellul?覿ren Karzinom [Guideline-based thermal ablation of hepatocellular carcinoma][J].Radiologe,2022,62(3):219-224.[28]Minami Y,Nishida N,Kudo M.Therapeutic response assessment of RFA for HCC: contrast-enhanced US, CT and MRI[J].World J Gastroenterol,2014,20(15):4160-4166.

相似文献/References:

[1]朱志成,陈玉赞.鼻中隔矫正联合筛前神经射频消融治疗变应性鼻炎伴鼻中隔偏曲的疗效分析[J].医学信息,2018,31(23):111.[doi:10.3969/j.issn.1006-1959.2018.23.030]
 ZHU Zhi-cheng,CHEN Yu-zan.The Curative Effect Analysis of Nasal Septal Reconstruction Combined with Nervus Ethmoidalis Anterior Under Radiofrequency Ablation for Allergic Rhinitis Patients with Septal Deviation[J].Journal of Medical Information,2018,31(20):111.[doi:10.3969/j.issn.1006-1959.2018.23.030]
[2]包学智.经肝动脉化疗栓塞联合射频消融术治疗中晚期原发性肝癌的效果[J].医学信息,2020,33(19):110.[doi:10.3969/j.issn.1006-1959.2020.19.033]
 BAO Xue-zhi.The Effect of Transhepatic Artery Chemoembolization Combined with Radiofrequency Ablation in the Treatment of Advanced Primary Liver Cancer[J].Journal of Medical Information,2020,33(20):110.[doi:10.3969/j.issn.1006-1959.2020.19.033]
[3]李显峰.超声引导下微波消融治疗甲状腺良性结节的效果及安全性[J].医学信息,2020,33(19):107.[doi:10.3969/j.issn.1006-1959.2020.19.032]
 LI Xian-feng.Effect and Safety of Ultrasound-guided Microwave Ablation in the Treatment of Benign Thyroid Nodules[J].Journal of Medical Information,2020,33(20):107.[doi:10.3969/j.issn.1006-1959.2020.19.032]
[4]银 丽,彭 俊,沈 翔,等.超声引导下罗哌卡因颈神经通路阻滞应用于甲状腺良性结节射频消融的半数有效浓度[J].医学信息,2025,38(04):102.[doi:10.3969/j.issn.1006-1959.2025.04.017]
 YIN Li,PENG Jun,SHEN Xiang,et al.Median Effective Concentration of Ultrasound-guided Cervical Nerve Block with Ropivacaine for Radiofrequency Ablation of Benign Thyroid Nodules[J].Journal of Medical Information,2025,38(20):102.[doi:10.3969/j.issn.1006-1959.2025.04.017]

更新日期/Last Update: 1900-01-01