当前位置： SCI文献检索 > JOURNAL OF THORACIC IMAGING期刊下所有文献 > Percutaneous radiofrequency ablation of lung tumors: evaluation of the literature using evidence-based techniques.

Percutaneous radiofrequency ablation of lung tumors: evaluation of the literature using evidence-based techniques.

Abstract：

PURPOSE:The aim of this study was to evaluate the literature for articles assessing radiofrequency ablation (RFA) for pulmonary malignancy. MATERIALS AND METHODS:The "bottom-up" approach to evidence-based practice was applied by 2 reviewers to the retrieval and appraisal of original research articles published on pulmonary RFA between 2002 and 2009. Primary lung cancer and pulmonary metastases data were analyzed separately. The relationship between the percentage of local recurrence rate and lesion size, patient age, follow-up duration, and time to local recurrence was assessed using Spearman's rank correlation. Discrete time series were used to evaluate time trends. RESULTS:Secondary evidence yielded 1 review of 26 observational studies. Primary evidence yielded 46 studies that seemed suitable for detailed appraisal. A total of 2905 ablations were performed in 1584 patients. Eight studies evaluated primary lung cancers alone, 11 evaluated pulmonary metastases alone, 25 evaluated both, and 2 did not specify the histology. Results revealed trends toward increasing use of conscious sedation over general anesthesia, increasing use of multitined probes, decreasing size of nodule selection, and use of positron emission tomography/computed tomography as the optimal follow-up tool. Mean morbidity was 24.6%. The most prevalent side effects included pneumothorax (28.3%), pleural effusions (14.8%), and pain (14.1%). Procedure-related mortality ranged from 0 to 5.6, with an overall procedure-related mortality rate of 0.21%. There were 282 (12.2%) local recurrences occurring at a mean of 13 months. The mean overall survival rate was 59.4%, and the cancer-specific survival rate was 82.6%. CONCLUSIONS:This evidence-based practice review of pulmonary RFA shows it to be a promising treatment for pulmonary malignancy in carefully selected patient populations. Studies with higher levels of evidence, including case-control, prospective nonrandomized and randomized trials, that compare RFA with alternative contemporary local treatments are urgently needed.

journal_name

J Thorac Imaging

journal_title

Journal of thoracic imaging

authors

Chan VO,McDermott S,Malone DE,Dodd JD

doi

10.1097/RTI.0b013e3181e48d5e

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

18-26

issue

eissn

0883-5993

issn

1536-0237

journal_volume

pub_type

杂志文章,评审

在线工具

Percutaneous radiofrequency ablation of lung tumors: evaluation of the literature using evidence-based techniques.