PDF(Pubmed)
Abstract：
OBJECTIVE: The current body of evidence lacks clarity regarding the comparative efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) as minimally invasive treatments for benign thyroid nodules. The primary objective of this study is to clarify these concerns.
METHODS: A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes.
RESULTS: Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06-0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury.
CONCLUSIONS: RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.
METHODS: A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes.
RESULTS: Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06-0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury.
CONCLUSIONS: RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.
摘要：
目的：目前的证据尚不清楚射频消融（RFA）和微波消融（MWA）作为甲状腺良性结节的微创治疗的疗效和安全性。这项研究的主要目的是澄清这些问题。
方法：使用Cochrane图书馆进行了全面搜索，Scopus,欧洲PMC,和Medline数据库直到10月10日，2023年，使用相关关键词的组合。这项研究纳入了比较RFA和MWA对良性甲状腺结节的文献。主要结果是从基线到随访的体积减少率（VRR）。次要结果是症状评分，化妆品评分,消融时间,主要并发症发生率，出血,声音嘶哑,皮肤烧伤,咳嗽,交感神经损伤.我们使用非随机干预研究中的偏倚风险（ROBINS-I）工具来评估纳入研究中的偏倚风险。我们采用随机效应模型来分析结果表示的标准化平均差（SMD）和比值比。
结果：纳入了9项2707个结节的研究。我们的荟萃分析结果表明，在1个月（SMD0.06；95％置信区间[CI]：-0.13至0.26；P=0.52）和3个月（SMD0.11；95％CI：-0.03至0.25；P=0.12）随访期间，RFA和MWA在VRR方面的疗效相似。在随访6（SMD0.25；95％CI：0.06-0.43；P=0.008）和12个月（SMD0.38；95％CI：0.17至0.59；P<0.001）时，RFA的VRR明显高于MWA。RFA和MWA在症状评分上没有显著差异，美容成绩,或者并发症的发生率，包括出血,声音嘶哑,皮肤烧伤,咳嗽,交感神经损伤.
结论：在6个月和12个月的随访中，RFA显示VRR高于MWA，具有可比的安全性。
方法：使用Cochrane图书馆进行了全面搜索，Scopus,欧洲PMC,和Medline数据库直到10月10日，2023年，使用相关关键词的组合。这项研究纳入了比较RFA和MWA对良性甲状腺结节的文献。主要结果是从基线到随访的体积减少率（VRR）。次要结果是症状评分，化妆品评分,消融时间,主要并发症发生率，出血,声音嘶哑,皮肤烧伤,咳嗽,交感神经损伤.我们使用非随机干预研究中的偏倚风险（ROBINS-I）工具来评估纳入研究中的偏倚风险。我们采用随机效应模型来分析结果表示的标准化平均差（SMD）和比值比。
结果：纳入了9项2707个结节的研究。我们的荟萃分析结果表明，在1个月（SMD0.06；95％置信区间[CI]：-0.13至0.26；P=0.52）和3个月（SMD0.11；95％CI：-0.03至0.25；P=0.12）随访期间，RFA和MWA在VRR方面的疗效相似。在随访6（SMD0.25；95％CI：0.06-0.43；P=0.008）和12个月（SMD0.38；95％CI：0.17至0.59；P<0.001）时，RFA的VRR明显高于MWA。RFA和MWA在症状评分上没有显著差异，美容成绩,或者并发症的发生率，包括出血,声音嘶哑,皮肤烧伤,咳嗽,交感神经损伤.
结论：在6个月和12个月的随访中，RFA显示VRR高于MWA，具有可比的安全性。
