经皮射频消融和无水乙醇注射治疗小肝癌meta分析

Comparison between percutaneous radiofrequency ablation and percutaneous ethanol injection for treatment of small hepatocellular carcinoma: a meta-analysis

目的评价射频消融治疗与经皮无水乙醇注射治疗小肝癌具有更好的临床疗效。方法计算机检索（截止至2014年6月）Pub Med、MEDLINE、EMBASE、EBSCO、Springer、Ovid和Cochrane图书馆等资料库临床对照试验资料。仅纳入通过生存率和局部复发率来比较经皮射频消融和无水乙醇注射治疗小肝癌效果的随机对照试验,对纳入研究的方法学及质量进行评价,并应用Rev Man 5.0软件进行统计分析。结果共纳入6个随机对照试验,共983名肝癌患者。Meta分析结果显示射频消融治疗较经皮无水乙醇注射能提高对直径≤5 cm且个数为1-3个的小肝癌的1-年、2-年、3-年生存率,也能显著降低1-年、2-年和3-年肿瘤局部复发率。结论经皮射频消融治疗小肝癌的总体疗效优于经皮无水乙醇注射治疗,且两种方法副作用均小,安全可靠。

Objective To conduct a systematic review to assess whether radiofrequency ablation（RFA）is superior topercutaneous ethanol injection（PEI）for treating small hepatocellular carcinoma（HCC）. Methods Randomized controlledtrials（RCTs）on evaluated survival rate and local occurrence rate of HCC with RFA and PEI therapy published in Pub Med,MEDLINE, EMBASE, EBSCO, Springer, Ovid and the Cochrane library up to June 2014 were retrieved. Only RCTs that wereand included. By evaluating methodology and quality of studies the data were calculated by the Rev Man 5.0 software forstatistical analysis. Results Six studies including 983 HCC patients were eligible for this analysis. Meta-analysis showedthat, compared with PEI, RFA could significantly improve 1-year, 2-year, 3-year survival rate, and reduce 1-year, 2-year, 3-year local recurrence rate in HCC（≤5 cm in diameter and n=1-3）. Conclusions The entire therapeutic effect of RFA issuperior to PEI in treatment of small HCCs and the two methods are safe with less side effect.RFA is worthy for clinicalapplications.