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Comparing cryoablation and microwave ablation for the treatment of patients with stage IIIB/IV non-small cell lung cancer.

比较冷冻消融和微波消融治疗 IIIB/IV 期非小细胞肺癌患者。

  • 影响因子:1.84
  • DOI:10.3892/ol.2019.11149
  • 作者列表:"Das SK","Huang YY","Li B","Yu XX","Xiao RH","Yang HF
  • 发表时间:2020-01-01
Abstract

:The aim of the present study was to compare the safety and efficacy of cryoablation (CA) and microwave ablation (MWA) as treatments for non-small cell lung cancer (NSCLC). Patients with stage IIIB or IV NSCLC treated with CA (n=45) or MWA (n=56) were enrolled in the present study. The primary endpoint was progression-free survival (PFS); the secondary endpoints included overall survival (OS) time and adverse events (AEs). The median PFS times between the two groups were not significantly different (P=0.36): CA, 10 months [95% confidence interval (CI), 7.5-12.4] vs. MWA, 11 months (95% CI, 9.5-12.4). The OS times between the two groups were also not significantly different (P=0.07): CA, 27.5 months (95% CI, 22.8-31.2 months) vs. MWA, 18 months (95% CI, 12.5-23.5). For larger tumors (>3 cm), patients treated with MWA had significantly longer median PFS (P=0.04; MWA, 10.5 months vs. CA, 7.0 months) and OS times (P=0.04; MWA, 24.5 months vs. CA, 14.5 months) compared patients treated with CA. However, for smaller tumors (≤3 cm), median PFS (P=0.79; MWA, 11.0 months vs. CA, 13.0 months) and OS times (P=0.39; MWA, 30.0 months vs. CA, 26.5 months) between the two groups did not differ significantly. The incidence rates of AEs were similar in the two groups (P>0.05). The number of applicators, tumor size and length of the lung traversed by applicators were associated with a higher risk of pneumothorax and intra-pulmonary hemorrhage in the two groups. Treatment with CA resulted in significantly less intraprocedural pain compared with treatment with MWA (P=0.001). Overall, the present study demonstrated that CA and MWA were comparably safe and effective procedures for the treatment of small tumors. However, treatment with MWA was superior compared with CA for the treatment of large tumors.

摘要

本研究的目的是比较冷冻消融 (CA) 和微波消融 (MWA) 治疗非小细胞肺癌 (NSCLC) 的安全性和有效性。接受 CA (n = 45) 或 MWA (n = 56) 治疗的 IIIB 期或 IV 期 NSCLC 患者入选本研究。主要终点是无进展生存期 (PFS); 次要终点包括总生存期 (OS) 时间和不良事件 (AEs)。两组间的中位 PFS 时间无显著差异 (P = 0.36): CA,10 个月 [95% 可信区间 (CI),7.5-12.4] vs. MWA, 11 个月 (95% CI,9.5-12.4)。两组间的 OS 时间也无显著差异 (P = 0.07): CA,27.5 个月 (95% CI,22.8-31.2 个月) vs. MWA,18 个月 (95% CI, 12.5-23.5)。对于较大的肿瘤 (> 3厘米),接受 MWA 治疗的患者的中位 PFS (P = 0.04; MWA,10.5 个月 vs. CA,7.0 个月) 和 OS 时间 (P = 0.04; MWA,24.5 个月 vs. CA,14.5 个月) 比较了 CA 治疗的患者。然而,对于较小的肿瘤 (≤ 3厘米),中位 PFS (P = 0.79; MWA,11.0 个月 vs. CA,13.0 个月) 和 OS 时间 (P = 0.39; MWA, 30.0 个月 vs. CA,26.5 个月) 两组之间无显著差异。两组不良反应发生率相似 (P>0.05)。两组中,敷贴器数量、肿瘤大小和经敷贴器穿过的肺长度与气胸和肺内出血的风险较高相关。与 MWA 治疗相比,CA 治疗导致术中疼痛明显减轻 (P = 0.001)。总体而言,本研究证明 CA 和 MWA 是治疗小肿瘤的相对安全和有效的方法。然而,MWA 治疗较 CA 治疗大肿瘤优越。

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影响因子:1.84
发表时间:2020-01-01
来源期刊:Oncology letters
DOI:10.3892/ol.2019.11149
作者列表:["Das SK","Huang YY","Li B","Yu XX","Xiao RH","Yang HF"]

METHODS::The aim of the present study was to compare the safety and efficacy of cryoablation (CA) and microwave ablation (MWA) as treatments for non-small cell lung cancer (NSCLC). Patients with stage IIIB or IV NSCLC treated with CA (n=45) or MWA (n=56) were enrolled in the present study. The primary endpoint was progression-free survival (PFS); the secondary endpoints included overall survival (OS) time and adverse events (AEs). The median PFS times between the two groups were not significantly different (P=0.36): CA, 10 months [95% confidence interval (CI), 7.5-12.4] vs. MWA, 11 months (95% CI, 9.5-12.4). The OS times between the two groups were also not significantly different (P=0.07): CA, 27.5 months (95% CI, 22.8-31.2 months) vs. MWA, 18 months (95% CI, 12.5-23.5). For larger tumors (>3 cm), patients treated with MWA had significantly longer median PFS (P=0.04; MWA, 10.5 months vs. CA, 7.0 months) and OS times (P=0.04; MWA, 24.5 months vs. CA, 14.5 months) compared patients treated with CA. However, for smaller tumors (≤3 cm), median PFS (P=0.79; MWA, 11.0 months vs. CA, 13.0 months) and OS times (P=0.39; MWA, 30.0 months vs. CA, 26.5 months) between the two groups did not differ significantly. The incidence rates of AEs were similar in the two groups (P>0.05). The number of applicators, tumor size and length of the lung traversed by applicators were associated with a higher risk of pneumothorax and intra-pulmonary hemorrhage in the two groups. Treatment with CA resulted in significantly less intraprocedural pain compared with treatment with MWA (P=0.001). Overall, the present study demonstrated that CA and MWA were comparably safe and effective procedures for the treatment of small tumors. However, treatment with MWA was superior compared with CA for the treatment of large tumors.

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影响因子:8.44
发表时间:2020-02-01
DOI:10.1016/j.annonc.2019.10.022
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