Clinical outcomes of radiofrequency ablation, percutaneous alcohol and acetic acid injection for hepatocelullar carcinoma: A meta-analysis
Clinical outcomes of radiofrequency ablation, percutaneous alcohol and acetic acid injection for hepatocelullar carcinoma: A meta-analysis
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DOI：
10.1016/j.jhep.2009.12.004
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发表时间：
2010-03-01
影响因子：
25.7
通讯作者：
Burroughs, Andrew Kenneth
中科院分区：
文献类型：
--
作者：
Germani, Giacomo;Pleguezuelo, Maria;Burroughs, Andrew Kenneth
背景与目的：射频消融治疗肝细胞癌是首选的局部消融治疗方法。经皮无水乙醇注射(PEI)较少使用，经皮醋酸注射(PAI)已基本放弃。缺乏强有力的证据表明一种疗法相对于另一种疗法的好处。我们的目的是利用荟萃分析技术对RFA、PEI和PAI进行比较的证据进行评估。方法：通过文献检索确定评估生存率、复发率、肿瘤完全坏死和并发症的对比研究。仅包括随机临床试验和准随机研究。结果：共纳入8项研究：RFA与PEI比较(n=5)，PAI与PEI比较(n=2)，RFA与PAI与PEI比较(n=1)，共1035例患者9项比较。在生存率(OR0.52；95%CI0.35~0.78；p=0.001)、肿瘤完全坏死和局部复发方面，射频消融组明显优于单纯射频消融组。对于肿瘤，2厘米。在评估的所有结果中，PAI与PEI没有显著差异。RFA和PAI的存活率相似。治疗肿瘤
Background & Aims: Radiofrequency ablation (RFA) is often the preferred local ablation therapy for hepatocellular carcinoma (HCC). Percutaneous ethanol injection (PEI) is less frequently used, and percutaneous acetic acid injection (PAI) has been mostly abandoned. Robust evidence showing benefit of one therapy versus another is lacking. Our aim was to evaluate the evidence comparing RFA, PEI and PAI using meta-analytical techniques.Methods: Literature search was undertaken until December 2008 to identify comparative studies evaluating survival, recurrence, complete necrosis of tumour and complications. Only randomized clinical trials and quasi-randomized studies were included. Adjusted indirect comparisons were made when direct comparative studies were insufficient.Results: Eight studies were identified: RFA vs. PEI (n = 5), PAI vs. PEI (n = 2) and RFA vs. PAI vs. PEI (n = 1) including 1035 patients with nine comparisons. RFA was superior to PEI for survival (OR 0.52; 95% CI 0.35-0.78; p = 0.001), complete necrosis of tumour and local recurrence. For tumours 2 cm. PAI did not differ significantly from PEI for all the outcomes evaluated. RFA and PAI have similar survival rates. For tumours