射频消融治疗晚期非小细胞肺癌疗效的荟萃分析

Radiofrequency ablation for the treatment of advanced non-small-cell lung cancer: a meta-analysis

目的 评价射频消融（RFA）治疗晚期非小细胞肺癌（NSCLC）的疗效.方法 计算机检索文献,对纳入文献的方法和质量进行评价,并用RevMan5.1.10版软件对RFA治疗晚期NSCLC的疗效进行荟萃分析.结果 共有11篇文献符合纳入标准.荟萃分析结果表明使用RFA治疗晚期NSCLC的有效率（CR＋ PR）是不使用RFA治疗的3.21倍（95％CI：1.94～5.31）、复发率为0.33倍（95％CI：0.20～ 0.57）、生存率为2.60倍（95％CI：1.90～ 3.55）、生活质量为4.79倍（95％CI：2.71～8.48）,且各组间差异均具有统计学意义（P＜0.05）,但使用RFA治疗组并发症的发生率也相对较高.结论 使用RFA治疗晚期NSCLC能够提高治疗疗效,降低复发率,提高生存率,改善患者的生活质量,但RFA治疗晚期NSCLC并发症发生率较高.对于RFA治疗晚期NSCLC的临床应用价值尚需进行大样本、多中心的、规范化、高质量临床研究进一步验证.

Objective To estimate the efficacy of percutaneous radiofrequency ablation （RFA） for the treatment of advanced non-small-cell lung cancer （NSCLC）.Methods The related medical literature,which were published from Jan.2000 to December 2012,were searched from Cochrane Library,PubMed,Web of knowledge,Embase,CBM,CNKI and Wanfang through computer system.By using the software of RevManS.l.10,meta-analysis of the clinical efficacy of RFA in treating advanced NSCLC was performed.Two reviewers independently retrieved the controlled trials and assessed the methodological quality.Results The results included 11 relevant controlled studies.Meta analysis indicated that the effective rate （CR ＋ PR） of RFA for advanced NSCLC was 3.21 times as that of non-RFA treatment （95% CI：1.94-5.31）.The recurrence rate was 0.33 times as that of non-RFA treatment （95%CI：0.20-0.57）,the survival rate was 2.60 times as that of non-RFA treatment （95%CI：1.90-3.55）,and the quality of life was 4.79 times as that of non-RFA treatment （95%CI：2.71-8.48）.Significant differences existed between the two groups.But the incidence of complications was relatively higher in RFA group than that in non-RFA group.Conclusion In treating advanced NSCLC radiofrequency ablation can improve the therapeutic effect,reduce the recurrence,increase the survival rate and improve the patient＇s quality of life,although the incidence of complications of RFA is a little higher.Larger sample,multi-center,standardized and high-quality clinical trials should be conducted in order to further clarify the clinical efficacy of RFA in treating advanced NSCLC.