局部微创消融治疗原发性肺癌的临床疗效的比较:一项网状Meta分析  

Comparison of clinical efficacy of local minimally invasive ablation for primary lung cancer:a network Meta-analysis

作　　者：张依品 连岩岩 上官子妍 郝万山[1] 姜敏[2] ZHANG Yipin;LIAN Yanyan;SHANGGUAN Ziyan;HAO Wanshan;JIANG Min(Beijing University of Chinese Medicine,Beijing 100029,China;Department of Oncology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院肿瘤科,北京1000780

出　　处：《癌症进展》2020年第23期2393-2397,2412,共6页Oncology Progress

基　　金：北京中医药大学2020年度基本科研业务费重点攻关项目(2020-JYB-ZDGG-123)。

摘　　要：目的采用网状Meta分析方法比较冷冻消融、射频消融或微波消融单独或联合治疗原发性肺癌的疗效,为临床提供循证依据。方法全面检索CNKI、维普、万方、the Cochrane Library、PubMed、Embase等数据库公开发表的关于冷冻消融、射频消融或微波消融治疗原发性肺癌的临床随机对照试验,检索时间为2016年1月至2020年7月,筛选出符合纳入标准的研究,按照Cochrane 5.1手册对纳入的研究进行文献质量评价与偏倚风险评估,采用ADDIS软件进行网状Meta分析与等级概率排序。结果共纳入28项研究,2336例患者。一致性模型检验结果显示,微创消融联合化疗的疗效优于化疗或微创消融单独应用;在提高肿瘤控制率和1年生存率方面,冷冻消融、射频消融或微波消融联合或单独应用无明显差异。等级概率排序结果显示,冷冻消融联合化疗和微波消融联合化疗的疗效相近,且均有可能优于射频消融联合化疗。结论联合疗法的疗效优于单独应用化疗或微创消融,冷冻消融和微波消融在控制肿瘤进展方面的效果更好,但在提高远期生存率方面无明显差异,但冷冻消融联合化疗有可能是更好的临床选择。Objective To compare the efficacy of cryoablation,radiofrequency ablation or microwave ablation alone or combined with reticular Meta-analysis for primaiy lung cancer,so as to provide evidence-based evidence for clinical practice.Method Comprehensive searched published clinical randomized controlled trials of cryoablation,radiofrequency ablation or microwave ablation for primary lung cancer from CNKI,VIP,WanFang,the Cochrane Library,PubMed,Embase database,the searching time range was from January 2016 to July 2020,and the studies that met the inclusion criteria were screened.The literature quality and bias risk were evaluated according to the Cochrane 5.1 manual.The Network Meta-analysis and rankogram were carried out by using ADDIS software.Result A total of 28 studies and 2336 patients were included.The results of consistency model test showed that the curative effect of minimally invasive ablation combined with chemotherapy was better than that of chemotherapy or minimally invasive ablation alone,and in improving disease control rate and 1-year survival rate.There was no significant difference between civoablation,radiofrequency ablation or microwave ablation alone.The results of rankogram showed that the therapeutic effects of ciyoablation combined with chemotherapy and microwave ablation combined with chemotherapy were similar,and both of them might be superior to radiofrequency ablation combined chemotherapy.Conclusion The clinical efficacy of combined therapy is better than that of chemotherapy or minimally invasive ablation alone.Ciyoablation and microwave ablation are better in controlling tumor progression,but there is no significant difference in improving long-term survival rate.However,ciyoablation combined with chemotherapy may be abetter clinical choice.

关 键 词：肺癌 化疗 冷消融 射频消融 微波消融 

分 类 号：R734.2[医药卫生—肿瘤]