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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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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. |
format | Online Article Text |
id | pubmed-6196668 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
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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