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目的评价射频消融治疗是否比经皮无水酒精注射治疗小肝癌具有更好的疗效。方法计算机检索MEDLINE(1966-2005年)、EMBASE(1989-2005年)、Cochrane图书馆临床对照试验资料库(2005年第1期)、互联网上注册临床试验数据库、中国生物医学文献数据库(1980-2005年),文献语种不限。纳入比较射频消融治疗和经皮无水酒精注射治疗小肝癌的随机对照试验,对纳入研究的方法学及质量进行评价,并应用RevMan4.2软件进行统计分析。结果共纳入4个随机对照试验。Meta分析结果表明,射频消融治疗较经皮无水酒精注射能提高对>2cm小肝癌的3年生存率、1年和3年无瘤生存率并减少1年和3年局部复发率;而对直径≤2cm的小肝癌,射频消融治疗与经皮无水酒精注射治疗效果相似,无显著差异。结论射频消融治疗小肝癌的总体疗效优于经皮无水酒精注射治疗,尤其对于肿瘤直径>2cm的小肝癌;且两种方法副作用均小,安全可靠。上述结论对于指导临床治疗小肝癌的方法选择具有很好的意义。
Objective To evaluate whether radiofrequency ablation is better than transdermal anhydrous ethanol in the treatment of small hepatocellular carcinoma. Methods The data of MEDLINE (1966-2005), EMBASE (1989-2005), Cochrane Central Register of Controlled Trials (2005), database of clinical trials registered on Internet, China Biomedical Literature Database (1980- 2005), literature language is not limited. Randomized controlled trials comparing radiofrequency ablation and percutaneous ethanol injection for the treatment of small hepatocellular carcinoma (HCC) were included. The methodology and quality of the included studies were evaluated. RevMan4.2 software was used for statistical analysis. Results A total of 4 randomized controlled trials were included. Meta analysis showed that radiofrequency ablation can improve 3-year survival rate, 1-year and 3-year disease-free survival rate and reduce 1-year and 3-year local recurrence rates for> 2cm small hepatocellular carcinoma compared with percutaneous ethanol injection. The small diameter of liver cancer ≤ 2cm, radiofrequency ablation and percutaneous ethanol injection treatment effect is similar, no significant difference. Conclusion The overall curative effect of radiofrequency catheter ablation on small hepatocellular carcinoma is better than percutaneous ethanol injection, especially for small hepatocellular carcinoma> 2cm in diameter. Both methods have less side effects and are safe and reliable. The above conclusion is of great significance to guide the selection of clinical treatment of small liver cancer.