Therapeutic comparison between radiofrequency ablation and percutaneous ethanol injection in treatment of primary liver cancer: a meta-analysis
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摘要:
目的探讨射频消融(RFA)和经皮无水乙醇注射(PEI)治疗肝癌的疗效比较。方法通过计算机检索Pub Med、EMBASE、Cochrane图书馆中国知网、重庆维普、万方等数据库,收集国内外关于RFA和PEI治疗肝癌临床疗效对比的文献,对文献质量进行评价,采用Rev Man5.0软件,利用固定效应模式及随机效应模式进行分析。结果共纳入7个随机对照试验,荟萃分析结果表明肝癌治疗后RFA组肿瘤坏死率显著高于PEI组,差异有统计学意义(P=0.008,OR=2.66,95%CI:1.29~5.48);与PEI组相比,RFA组1、2、3年生存率以及1、3年无瘤生存率明显提高,1、2、3年局部复发率显著降低,差异均有统计学意义(P值均<0.05);2年无瘤生存率比较,差异无统计学意义(P=0.06)。结论 RFA治疗肝癌的疗效优于PEI,这对指导临床肝癌治疗方法的选择具有较好的意义。
Abstract:Objective To compare the efficacy of radiofrequency ablation( RFA) versus percutaneous ethanol injection( PEI) in the treatment of primary liver cancer( PLC). Methods A search of Pub Med,EMBASE,CKNI,VIP,and Wanfang Data identified all randomized controlled trials( RCTs) related to therapeutic comparison between RFA and PEI in patients with PLC. Quality of each study was assessed,meta- analysis was performed with Review Manager 5. 0 software,and the results were analyzed with fixed effect model and random effect model. Results Seven RCTs were included in this study. The results of meta- analysis indicated that,compared with the PEI group,the RFA group had a significantly higher tumor necrosis rate( P = 0. 008,OR = 2. 66,95% CI: 1. 29- 5. 48). The 1-,2-,and 3- year survival rates and 1- and 3- year tumor- free survival rates of the RFA group were significantly higher than those of the PEI group( P <0. 05). The RFA group had significantly lower 1-,2-,and 3- year local recurrence rates in comparison with the PEI group( P < 0. 05).There was no significant difference in 2- year tumor- free survival rate between the two groups( P = 0. 06). Conclusion The efficacy of RFA is superior to that of PEI,which is of clinical significance to guide the selection of methods for PLC treatment.
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Key words:
- liver neoplasms /
- catheter ablation /
- percutaneous ethanol injection /
- Meta-analysis
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