Comparison of the Effectiveness of Radiofrequency Ablation with Stereotactic Body Radiation Therapy in Inoperable Stage I Non-Small Cell Lung Cancer: A Systemic Review and Meta-analysis
Introduction: Stereotactic body radiation therapy (SBRT) and Radiofrequency ablation (RFA) are two important treatment options for medically inoperable patients with stage Ⅰ non-small cell lung cancer (NSCLC).Here we performed a meta-analysis to compare clinical outcomes of these two techniques.Methods: Literature search for trials published from January 2001 to July 2012 was undertaken.Meta-analyses were performed to obtain pooled overall survival (OS), local tumor control rates (LCR), and the adverse events.Regression analysis was conducted considering each study”s proportions of stage ⅠA and age.Results: Thirty-one studies on SBRT (2767 patients) and 13 studies on RFA (328 patients) were eligible.LCR (95% confidence interval) at 1, 2, 3 and 5 years for RFA was 77% (70-85%), 48% (37-58%), 55% (47-62%), and 42% (30-54%) respectively, which was significantly lower than that for SBRT: 97 % (96-98%), 92% (91-94%), 88% (86-90%), and 86% (85-88%)(P<.001).These differences remained significant after correcting for stage ⅠA and age (P<.001 at 1 year, 2 years and 3 years; P=.04 at 5 years).The effect of RFA was not different from that of SBRT on OS (P>.05).The most frequent complication of RFA is pneumothorax, occurring in 30.9% of patients, while that for SBRT (≥grade 3) is radiation pneumonitis, occurring in 2.2% of patients.Conclusions: Comparing to RFA, SBRT has higher LCR, but similar OS.However, caution is warranted due to the limited number of RFA studies.
Non-small cell lung cancer Stage Ⅰ Medically inoperable Radiofrequency ablation Stereotactic body radiation therapy
Nan Bi Kerby Shedden Xiangpeng Zheng Luhua Wang Feng-Ming (Spring) Kong
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI; Department of Radiation Onc Department of Biostatistics, University of Michigan, Ann Arbor, MI Department of Radiation Oncology, University of Michigan, Ann Arbor, MI Department of Radiation Oncology, Cancer Hospital & Institute, Chinese Academy of Medical Sciences ( Department of Radiation Oncology, GRU Cancer Center/Medical College of Georgia,Georgia Regents Unive
国内会议
北京
英文
28-36
2014-01-11（万方平台首次上网日期，不代表论文的发表时间）