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Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis

OBJECTIVE: The objective of this study was to compare the efficacy and safety of radiofrequency ablation (RFA), cryoablation, and microwave ablation (MWA) for patients with lung malignancies. METHODS: We performed a network meta-analysis to identify both direct and indirect evidence from relevant tr...

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Autores principales: Jiang, Binghu, Mcclure, Morgan A., Chen, Tianming, Chen, Shilin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196668/
https://www.ncbi.nlm.nih.gov/pubmed/30416597
http://dx.doi.org/10.4103/atm.ATM_392_17
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author Jiang, Binghu
Mcclure, Morgan A.
Chen, Tianming
Chen, Shilin
author_facet Jiang, Binghu
Mcclure, Morgan A.
Chen, Tianming
Chen, Shilin
author_sort Jiang, Binghu
collection PubMed
description OBJECTIVE: The objective of this study was to compare the efficacy and safety of radiofrequency ablation (RFA), cryoablation, and microwave ablation (MWA) for patients with lung malignancies. METHODS: We performed a network meta-analysis to identify both direct and indirect evidence from relevant trials by searching PubMed, Embase, and the Cochrane Library to December 31, 2017, for the treatment of malignant lung tumors with the use of RFA, MWA, or cryoablation. We extracted the relevant information from the published studies with a predefined data sheet and assessed the risk of bias with the Cochrane risk of bias tool. The primary outcomes were efficacy (local progression rate and overall survival rate) and safety (major complications rate). We did a random-effects network meta-analysis within a Bayesian framework as well as assessed the quality of evidence contributing to each network estimate using GRADE framework. RESULTS: We collected 34 studies eligible which included 1840 participants and 2520 lung malignancies (1318 primary lung cancer and 1202 pulmonary metastatic tumors). The quality of evidence was rated as very low in most comparisons. From the point of local progression rate, RFA and MWA were significantly more effective than cryoablation with odds ratio (OR) of 0.04 (95% confidence interval [CI]: 0.004, 0.38; P = 0.005) and 0.02 (95% CI: 0.002, 0.24; P = 0.001), respectively. No significant difference was found between MWA and RFA with an OR of 0.63 (95% CI: 0.04, 10.39; P = 0.745). Regarding the major complications, RFA, MWA, and cryoablation showed the comparable safety (P > 0.05). CONCLUSION: RFA and MWA offer an advantage over cryoablation for patients with malignant lung tumors.
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spelling pubmed-61966682018-11-09 Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis Jiang, Binghu Mcclure, Morgan A. Chen, Tianming Chen, Shilin Ann Thorac Med Original Article OBJECTIVE: The objective of this study was to compare the efficacy and safety of radiofrequency ablation (RFA), cryoablation, and microwave ablation (MWA) for patients with lung malignancies. METHODS: We performed a network meta-analysis to identify both direct and indirect evidence from relevant trials by searching PubMed, Embase, and the Cochrane Library to December 31, 2017, for the treatment of malignant lung tumors with the use of RFA, MWA, or cryoablation. We extracted the relevant information from the published studies with a predefined data sheet and assessed the risk of bias with the Cochrane risk of bias tool. The primary outcomes were efficacy (local progression rate and overall survival rate) and safety (major complications rate). We did a random-effects network meta-analysis within a Bayesian framework as well as assessed the quality of evidence contributing to each network estimate using GRADE framework. RESULTS: We collected 34 studies eligible which included 1840 participants and 2520 lung malignancies (1318 primary lung cancer and 1202 pulmonary metastatic tumors). The quality of evidence was rated as very low in most comparisons. From the point of local progression rate, RFA and MWA were significantly more effective than cryoablation with odds ratio (OR) of 0.04 (95% confidence interval [CI]: 0.004, 0.38; P = 0.005) and 0.02 (95% CI: 0.002, 0.24; P = 0.001), respectively. No significant difference was found between MWA and RFA with an OR of 0.63 (95% CI: 0.04, 10.39; P = 0.745). Regarding the major complications, RFA, MWA, and cryoablation showed the comparable safety (P > 0.05). CONCLUSION: RFA and MWA offer an advantage over cryoablation for patients with malignant lung tumors. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6196668/ /pubmed/30416597 http://dx.doi.org/10.4103/atm.ATM_392_17 Text en Copyright: © 2018 Annals of Thoracic Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Jiang, Binghu
Mcclure, Morgan A.
Chen, Tianming
Chen, Shilin
Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis
title Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis
title_full Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis
title_fullStr Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis
title_full_unstemmed Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis
title_short Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis
title_sort efficacy and safety of thermal ablation of lung malignancies: a network meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196668/
https://www.ncbi.nlm.nih.gov/pubmed/30416597
http://dx.doi.org/10.4103/atm.ATM_392_17
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