Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis
BackgroundRadiofrequency ablation (RFA) and chemotherapy are used to treat lung cancer or pulmonary metastases, but no direct comparison of overall survival (OS) has been published. The present study aimed to assess the OS of RFA and/or chemotherapy in patients with lung cancer or pulmonary metastas...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1240149/full |
| _version_ | 1797665288404074496 |
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| author | Ziyi Yang Xia Lyu Huilin Yang Bingbing Wang Dan Xu Lingyi Huo Runzi Zhang Yingjun Huang Benshu Diao |
| author_facet | Ziyi Yang Xia Lyu Huilin Yang Bingbing Wang Dan Xu Lingyi Huo Runzi Zhang Yingjun Huang Benshu Diao |
| author_sort | Ziyi Yang |
| collection | DOAJ |
| description | BackgroundRadiofrequency ablation (RFA) and chemotherapy are used to treat lung cancer or pulmonary metastases, but no direct comparison of overall survival (OS) has been published. The present study aimed to assess the OS of RFA and/or chemotherapy in patients with lung cancer or pulmonary metastases who were not candidates for surgical resection.MethodsTo identify relevant studies, the following databases were electronically searched from their inception to 31 March 2023: PubMed, Embase, Web of Science, Cochrane Library, Scopus, Ovid, ScienceDirect, SinoMed, China National Knowledge Infrastructure Database, Chongqing VIP Chinese Science and Technology Periodical Database, Wanfang Database, LILACS, ClinicalTrials.gov, and Chictr.org. Manual retrieval was also conducted. We used published hazard ratios (HRs) if available or estimates from other survival data.ResultsA total of 1,387 participants from 14 trials were included in the final analysis. Patients treated with RFA combined with chemotherapy significantly improved OS compared with those treated with chemotherapy alone [HR 0.50, 95% confidence interval (CI) 0.41–0.61; p < 0.00001], with an absolute difference at 12 months of 29.6% (95% CI 23.7–35.5), at 24 months of 19.2% (95% CI 10.1–28.2), and at 36 months of 22.9% (95% CI 12.0–33.7). No statistically significant difference was observed in the subgroups of case type, cancer type, chemotherapy drugs, and tumor size. The HR for OS with RFA plus chemotherapy vs. RFA alone was 0.53 (95% CI 0.41–0.70; p < 0.00001), corresponding to a 27.1% (95% CI 18.3–35.8), 31.0% (95% CI 19.9–41.9), and 24.9% (95% CI 15.0–34.7) absolute difference in survival at 12 months, 24 months, and 36 months, respectively. Subgroup analysis by geographic region and TNM stage showed that RFA combined with chemotherapy still significantly improved OS compared to RFA. The HR of RFA vs. chemotherapy was 0.98 (95% CI 0.60–1.60; p = 0.94), with an absolute difference at 12 months of 1.4% (95% CI -19.2 to 22.1), at 24 months of 7.8% (95% CI -11.3 to 26.8), and at 36 months of 0.3% (95% CI -13.2 to 13.8). The overall indirect comparison of OS for RFA vs. chemotherapy was 0.95 (95% CI 0.72–1.26; p = 0.74). Data on progression-free survival were not sufficiently reported.ConclusionRFA combined with chemotherapy might be a better treatment option for patients with lung cancer or pulmonary metastases than chemotherapy alone or RFA alone. The comparison between RFA and/or chemotherapy remains to be specifically tested.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=335032, identifier CRD42022335032. |
| first_indexed | 2024-03-11T19:42:47Z |
| format | Article |
| id | doaj.art-b71948cb515c4dc2a2a8c0edb792c475 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-11T19:42:47Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-b71948cb515c4dc2a2a8c0edb792c4752023-10-06T07:56:13ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-10-011410.3389/fimmu.2023.12401491240149Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysisZiyi YangXia LyuHuilin YangBingbing WangDan XuLingyi HuoRunzi ZhangYingjun HuangBenshu DiaoBackgroundRadiofrequency ablation (RFA) and chemotherapy are used to treat lung cancer or pulmonary metastases, but no direct comparison of overall survival (OS) has been published. The present study aimed to assess the OS of RFA and/or chemotherapy in patients with lung cancer or pulmonary metastases who were not candidates for surgical resection.MethodsTo identify relevant studies, the following databases were electronically searched from their inception to 31 March 2023: PubMed, Embase, Web of Science, Cochrane Library, Scopus, Ovid, ScienceDirect, SinoMed, China National Knowledge Infrastructure Database, Chongqing VIP Chinese Science and Technology Periodical Database, Wanfang Database, LILACS, ClinicalTrials.gov, and Chictr.org. Manual retrieval was also conducted. We used published hazard ratios (HRs) if available or estimates from other survival data.ResultsA total of 1,387 participants from 14 trials were included in the final analysis. Patients treated with RFA combined with chemotherapy significantly improved OS compared with those treated with chemotherapy alone [HR 0.50, 95% confidence interval (CI) 0.41–0.61; p < 0.00001], with an absolute difference at 12 months of 29.6% (95% CI 23.7–35.5), at 24 months of 19.2% (95% CI 10.1–28.2), and at 36 months of 22.9% (95% CI 12.0–33.7). No statistically significant difference was observed in the subgroups of case type, cancer type, chemotherapy drugs, and tumor size. The HR for OS with RFA plus chemotherapy vs. RFA alone was 0.53 (95% CI 0.41–0.70; p < 0.00001), corresponding to a 27.1% (95% CI 18.3–35.8), 31.0% (95% CI 19.9–41.9), and 24.9% (95% CI 15.0–34.7) absolute difference in survival at 12 months, 24 months, and 36 months, respectively. Subgroup analysis by geographic region and TNM stage showed that RFA combined with chemotherapy still significantly improved OS compared to RFA. The HR of RFA vs. chemotherapy was 0.98 (95% CI 0.60–1.60; p = 0.94), with an absolute difference at 12 months of 1.4% (95% CI -19.2 to 22.1), at 24 months of 7.8% (95% CI -11.3 to 26.8), and at 36 months of 0.3% (95% CI -13.2 to 13.8). The overall indirect comparison of OS for RFA vs. chemotherapy was 0.95 (95% CI 0.72–1.26; p = 0.74). Data on progression-free survival were not sufficiently reported.ConclusionRFA combined with chemotherapy might be a better treatment option for patients with lung cancer or pulmonary metastases than chemotherapy alone or RFA alone. The comparison between RFA and/or chemotherapy remains to be specifically tested.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=335032, identifier CRD42022335032.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1240149/fulllung cancerpulmonary metastasesradiofrequency ablationchemotherapysystematic reviewmeta-analysis |
| spellingShingle | Ziyi Yang Xia Lyu Huilin Yang Bingbing Wang Dan Xu Lingyi Huo Runzi Zhang Yingjun Huang Benshu Diao Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis Frontiers in Immunology lung cancer pulmonary metastases radiofrequency ablation chemotherapy systematic review meta-analysis |
| title | Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis |
| title_full | Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis |
| title_fullStr | Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis |
| title_full_unstemmed | Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis |
| title_short | Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis |
| title_sort | survival after radiofrequency ablation and or chemotherapy for lung cancer and pulmonary metastases a systematic review and meta analysis |
| topic | lung cancer pulmonary metastases radiofrequency ablation chemotherapy systematic review meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1240149/full |
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