Department of Oncology, General Hospital of Yangquan Coal Industry Group, Yangquan, Shanxi Province, China.
Department of Oncology and Interventional Radiology, Yang Quan Hospital of Shanxi Medical University, Yangquan, Shanxi Province, China.
Endocrine. 2024 Sep;85(3):979-987. doi: 10.1007/s12020-024-03782-8. Epub 2024 Mar 22.
This study aimed to compare efficacy and safety of minimally invasive therapies such as radiofrequency ablation (RFA), microwave ablation (MWA), ethanol ablation (EA), and laser ablation (LA) for thyroid nodules through network meta-analysis (NMA).
This study searched PubMed, Web of Science, Embase, and The Cochrane Library databases to collect randomized controlled trials (RCTs) or cohort studies comparing efficacy and safety of different minimally invasive therapies for thyroid nodules. Newcastle-Ottawa Scale (NOS) was implemented to assess quality of included cohort studies, and Cochrane risk of bias assessment tool was utilized to evaluate quality of included RCTs. Eligible studies contained at least one of the following clinical outcome measures: volume reduction rate (VRR), symptom score, cosmetic score, nodule regrowth rate, and complication rate. STATA software was utilized for NMA.
Sixteen eligible studies (4 RCTs, 11 retrospective cohort studies, 1 prospective cohort study) involved 4094 patients. NMA results revealed that RFA group had the highest VRR at 1 months and 12 months. There were no significant differences in symptom scores and cosmetic scores among all treatment methods, with the lowest symptom scores and cosmetic scores in RFA group. LA group had a significantly higher nodule regrowth rate than RFA and MWA groups, with the lowest in RFA group. There were no significant differences in complication rate among all treatment methods.
RFA had the highest VRR for thyroid nodules, and it excelled in symptom scores, cosmetic scores, and nodule regrowth rates.
本研究旨在通过网络荟萃分析（NMA）比较射频消融（RFA）、微波消融（MWA）、乙醇消融（EA）和激光消融（LA）等微创治疗甲状腺结节的疗效和安全性。
本研究检索了 PubMed、Web of Science、Embase 和 The Cochrane Library 数据库，以收集比较不同微创治疗甲状腺结节的疗效和安全性的随机对照试验（RCT）或队列研究。采用纽卡斯尔-渥太华量表（NOS）评估纳入队列研究的质量，采用 Cochrane 偏倚风险评估工具评价纳入 RCT 的质量。合格研究至少包含以下临床结局指标之一：体积缩小率（VRR）、症状评分、美容评分、结节复发率和并发症发生率。采用 STATA 软件进行 NMA。
纳入了 16 项合格研究（4 项 RCT、11 项回顾性队列研究、1 项前瞻性队列研究），涉及 4094 名患者。NMA 结果显示，RFA 组在 1 个月和 12 个月时的 VRR 最高。所有治疗方法的症状评分和美容评分均无显著差异，RFA 组的症状评分和美容评分最低。LA 组的结节复发率明显高于 RFA 和 MWA 组，RFA 组的结节复发率最低。所有治疗方法的并发症发生率均无显著差异。
RFA 治疗甲状腺结节的 VRR 最高，在症状评分、美容评分和结节复发率方面表现出色。
