Zhao Q, Tian G, Kong D, Jiang T
Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
J Endocrinol Invest. 2016 Aug;39(8):909-16. doi: 10.1007/s40618-016-0450-8. Epub 2016 Mar 15.
Our aim was to evaluate the efficacy of ultrasound-guided radiofrequency ablation (RFA) for localized recurrent thyroid cancers.
We did a systematic review and meta-analysis of the scientific literature by searching the PubMed, Embase, Web of Science,Scopus and the Cochrane Library up to November 26, 2015. We assessed the pooled standard mean difference (SMD) of nodule volume, largest diameter and serum thyroglobulin (Tg) level by comparing pre-RFA with post-RFA using fixed or random-effects model. The Newcastle-Ottawa Scale was used to evaluate the methodological quality of the included studies, risk of bias in the selective populations, comparability of groups and exposure.
We finally identified nine articles including 189 patients (male: 54 and female: 135) with 255 tumor lesions, who underwent ultrasound (US)-guided RFA beyond the mean 6 months of follow-up. The results showed that tumor volume (SWD: 0.77, 95 % CI: 0.57-0.97, I (2) = 25.9 %, p = 0.231), largest diameter (SWD: 1.56, 95 % CI: 0.94-2.17, I (2) = 82.6 %, p < 0.001) and Tg level (SWD: 0.52, 95 % CI: 0.30-0.73, I (2) = 0 %, p = 0.493) were decreased and no significant publication bias was detectable.
The pooled data indicated that the prognosis improved for patients with localized recurrent thyroid cancers and RFA is a promising treatment for these patients with infeasible surgery.
我们的目的是评估超声引导下射频消融术(RFA)治疗局部复发性甲状腺癌的疗效。
我们通过检索截至2015年11月26日的PubMed、Embase、Web of Science、Scopus和Cochrane图书馆对科学文献进行了系统评价和荟萃分析。我们使用固定效应或随机效应模型,通过比较射频消融术前和术后的情况,评估结节体积、最大直径和血清甲状腺球蛋白(Tg)水平的合并标准平均差(SMD)。采用纽卡斯尔-渥太华量表评估纳入研究的方法学质量、选择性人群中的偏倚风险、组间可比性和暴露情况。
我们最终确定了9篇文章,包括189例患者(男性54例,女性135例),共255个肿瘤病灶,这些患者接受了超声引导下的射频消融术,平均随访时间超过6个月。结果显示,肿瘤体积(标准化平均差:0.77,95%可信区间:0.57 - 0.97,I² = 25.9%,p = 0.231)、最大直径(标准化平均差:1.56,95%可信区间:0.94 - 2.17,I² = 82.6%,p < 0.001)和Tg水平(标准化平均差:0.52,95%可信区间:0.30 - 0.73,I² = 0%,p = 0.493)均有所下降,且未检测到明显的发表偏倚。
汇总数据表明,局部复发性甲状腺癌患者的预后有所改善,射频消融术是这些手术不可行患者的一种有前景的治疗方法。