Xiang Jianfeng, Liu Ming, Lu Rongbin, Wang Ligang, Xu Yujun, He Xiangmeng, Blanco Roberto, Li Chengli
Department of Interventional MRI, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan, Shandong; Department of Intervention, Shanghai Fengxian District Central Hospital, Shanghai, China.
Department of Interventional MRI, Shandong Key Laboratory of Advanced Medical Imaging Technologies and Applications, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan, Shandong, China.
J Cancer Res Ther. 2020 Sep;16(5):1093-1099. doi: 10.4103/jcrt.JCRT_1115_19.
The purpose of this study is to study the clinical outcomes of different types of magnetic resonance (MR)-guided ablation for the treatment of liver tumors by performing a systematic review and pooled analysis.
A comprehensive literature search was performed for clinical trials published from January 1997 to October 2019 in PubMed, the Web of Science, Embase, and the Cochrane Library. Pooled analyses were performed to obtain the complete ablation (CA), complication, progression-free survival (PFS), and overall survival (OS) rates.
Thirty studies were eligible, including four studies on MR-guided microwave ablation (MWA); 14 studies on MR-guided radiofrequency ablation (RFA); one study on both MR-guided MWA and RFA; eight studies on MR-guided, laser-induced thermotherapy (LITT); two studies on MR-guided percutaneous cryoablation (PC); and one study on MR-guided percutaneous ethanol injection (PEI). The CA rates in patients who underwent RFA, MWA, LITT, PC, and PEI were 95.60%, 98.86%, 77.78%, 47.92%, and 85.71%, respectively. The most frequent complications were pain (27.66%, 13/47) and postablation syndrome (27.66%, 13/47) in the PC group; pleural effusion (8.11%, 119/1,468) and subcapsular hematoma (2.25%, 33/1,468) in the LITT group; pleural effusion (2.67%, 2/75) in the MWA group; and subcapsular hematoma (4.18%, 20/478) and post-ablation syndrome (2.93%, 14/478) in the RFA group. There were few studies reporting PFS and OS.
MR-guided ablation is a practicable alternative treatment for liver tumors, especially MR-guided RFA and MWA, which have high rates of CA and low occurrences of complications.
本研究旨在通过系统评价和汇总分析，研究不同类型的磁共振（MR）引导下消融治疗肝肿瘤的临床疗效。
对1997年1月至2019年10月在PubMed、科学网、Embase和Cochrane图书馆发表的临床试验进行全面的文献检索。进行汇总分析以获得完全消融（CA）、并发症、无进展生存期（PFS）和总生存期（OS）率。
30项研究符合条件，包括4项关于MR引导下微波消融（MWA）的研究；14项关于MR引导下射频消融（RFA）的研究；1项关于MR引导下MWA和RFA的研究；8项关于MR引导下激光诱导热疗（LITT）的研究；2项关于MR引导下经皮冷冻消融（PC）的研究；以及1项关于MR引导下经皮乙醇注射（PEI）的研究。接受RFA、MWA、LITT、PC和PEI治疗的患者的CA率分别为95.60%、98.86%、77.78%、47.92%和85.71%。PC组最常见的并发症是疼痛（27.66%，13/47）和消融后综合征（27.66%，13/47）；LITT组是胸腔积液（8.11%，119/1468）和包膜下血肿（2.25%，33/1468）；MWA组是胸腔积液（2.67%，2/75）；RFA组是包膜下血肿（4.18%，20/478）和消融后综合征（2.93%，14/478）。报告PFS和OS的研究较少。
MR引导下消融是肝肿瘤的一种可行的替代治疗方法，尤其是MR引导下的RFA和MWA，其CA率高且并发症发生率低。
