射频消融治疗肝硬化型小肝癌临床效果的循证分析

目的 通过比较射频消融(RFA)与手术切除在小肝癌治疗中的临床疗效,从而评价RFA对小肝癌的价值.方法 计算机检索MEDLINE(1966-2008年)、EMBASE(1966-2008年)、中国生物医学文献数据库(CBMdisc,1978-2008年)、Cochrane图书馆、循证医学评价(Ovid版)和Cancerlit(1993-2008年)等数据库,截止日期2008年1月1日,文献语种不限.纳入比较射频消融与手术切除治疗小肝癌的随机对照试验和非随机对照试验,统计分析采用RevMan 4.2版软件.结果 纳入了4个前瞻性研究和2个回顾性研究.荟萃分析结果表明,RFA与手术切除治疗小肝癌后1、3、4年生存率和1年无瘤生存率均无统计学差异(P>0.05);但手术切除在提高3年无瘤生存率方面优于RFA(P<0.05).结论 RFA治疗小肝癌疗效与手术切除相近,适应于作为肝硬化型小肝癌的首选治疗方法.

Therapeutic clinical effect of radiofrequency ablation for small hepatocellular carcinoma in cirrhotic patients:a meta-analysis

Objective To evaluate the value of radiofrequency ablation in the treatment of small hepatocellular carcinoma(HCC).Methods MEDLINE(1966-2008),EMBASE(1966-2008).CBMdisc (1978-2008)were searched.The Cochrane Library,Evidence Base Medicine Reviews(Ovid Edition),Cancerlit(1993-2008)and so on,date of last search:30 January 2008.There were no restrictioas in language.Randomized controlled trials(RCTs)and non-RCTs were both included in this study,and the quality of each inchded studvy was assessed.Meta-analysis was performed bv RevMan 4.2 software.ResultsFour prospective controlled studies and two retrospective studies met the inclusion criteria.The results of meta-analysis showed that 1-.3-.4-year survival rates and 1-year tumor-free survival rate had not statistically significant difference in RFA group compared with surgical resection group(P>0.05),but surgical resection Wag more effective to improve 3-year tumor-free survival rate than RFA(P<0.05).Conclusions The effect of RFA therapy on small HCC is similar to resection,RFA could be considered as the first-line treatment of choice for surgical candidates with small HCC in cirrhotic patients.