目的:本研究的目的是评估热消融的安全性和有效性,包括射频消融(RFA)和微波消融(MWA),对于I期非小细胞肺癌(NSCLC)患者。
方法:检索PubMed数据库至2023年11月,以确定相关研究。用R版本3进行统计分析。6.3.
结果:最终纳入了涉及1400名患者的33项研究。根据我们的研究,60岁以上的I期NSCLC患者的发病率为98%(95%CI[94-100%]);病变主要位于RUL(右上叶)和LUL(左上叶),两个部位的发病率分别为29%(95%CI[23-35%])和27%(95%CI[21-33%]),分别;肺癌的类型主要包括腺癌,鳞癌,大细胞肺癌,其中腺癌占最大比例,为63%(95%CI[56-70%]);死亡原因主要分为癌症相关(57%,95CI[40-74%])和非癌症相关(40%,95CI[23-58%]);术后期间的常见并发症是气胸和疼痛,发病率为33%(95CI[24-44%])和33%(95CI[19-50%]),MWA的术后并发症发生率略高于RFA;局部复发率为23%(95CI[17-29%]),远处复发率为18%(95CI[7-32%]);合并结果显示1-,2-,3-,5年生存率为96%,81%,68%,42%,1、2、3和5年的癌症特异性生存率(CSS)为98%,88%,75%,58%,1、2、3和5年的无病生存率(DFS)为87%,63%,57%,42%,RFA组与MWA组的生存率差异无统计学意义,CSS和DFS。
结论:消融治疗对I期NSCLC患者安全有效。MWA和RFA的疗效相当,安全,和预后,可推荐用于Ⅰ期NSCLC患者,尤其是对于不能耐受开放手术的患者。
OBJECTIVE: The objective of this study was to measure the safety and efficacy of thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), for patients with stage I non-small cell lung cancer (NSCLC).
METHODS: The databases PubMed was searched from inception to November 2023 to identify relevant studies. Statistical analyses were performed with R version 3. 6. 3.
RESULTS: Thirty-three studies involving 1400 patients were finally included. According to our study, the incidence of patients with stage I NSCLC who were older than 60 years old was 98 % (95 % CI [94-100 %]); the lesions were mostly located in RUL (Right Upper Lobe) and LUL (Left Upper Lobe), and the incidence of the two sites was 29 % (95 % CI [23-35 %]) and 27 % (95 % CI [21-33 %]), respectively; the types of lung cancers mainly included adenocarcinoma, squamous carcinoma, and large-cell lung cancer, of which adenocarcinoma accounted for the largest proportion of 63 % (95 % CI [56-70 %]); the causes of death were mainly categorized into cancer-related (57 %, 95 %CI[40-74 %]) and noncancer-related (40 %, 95 %CI [23-58 %]); the common complications in the postoperative period were pneumothorax and pain, with the incidence of 33 % (95 %CI[24-44 %]) and 33 % (95 %CI[19-50 %]), and the rate of the postoperative complications in MWA was slightly higher than those in RFA; the local recurrence rate was 23 % (95 %CI[17-29 %]) and the distant recurrence rate was 18 % (95 %CI[7-32 %]); the pooling result showed the rate of 1-, 2-, 3-, and 5-year survival rate were 96 %, 81 %, 68 %, and 42 %, the Cancer-specific survival (CSS) rates at 1, 2, 3, and 5 years were 98 %, 88 %, 75 %, and 58 %, Disease-free survival (DFS) rates at 1, 2, 3, and 5 years were 87 %, 63 %, 57 %, and 42 %, there were no significant differences existed between the RFA group and MWA group in survival rate, CSS and DFS.
CONCLUSIONS: Ablation therapy is safe and effective for stage I NSCLC patient. MWA and RFA have comparable efficacy, safety, and prognosis, which could be recommended for patients with stageⅠNSCLC, especially for patients who cannot tolerate open surgery.