Radiofrequency ablation versus microwave ablation for lung cancer/lung metastases: a meta-analysis

Both radiofrequency ablation (RFA) and microwave ablation (MWA) are commonly used non-surgical treatment methods for lung cancer/lung metastases (LC/LM). However, there is still debate over which one is superior. The meta-analysis was conducted to evaluate the effectiveness and safety between the two groups.

Seven databases were systematically searched for relevant literature comparing RFA versus MWA in the treatment of LC/LM. The primary outcome assessed was survival, while secondary outcomes included ablation efficacy rate, recurrence, and complications.

Ten studies were included, comprising 433 patients in the RFA group and 526 in the MWA group. The RFA group exhibited longer overall survival (OS) time (mean difference [MD]: 1.95 [0.43, 3.48] months) and progression-free survival (PFS) time (MD: 3.00 [2.31, 3.69] months) compared to the MWA group. Progression-free survival rates (PFSR) at 1 and 2 years were superior in the RFA group, with the advantage of PFSR increasing with prolonged survival time. However, the ablation duration (MD: 5.78 [3.54, 8.01] min) was longer in the RFA group. Both groups showed similar rates of recurrence, complete ablation (initial and subsequent sessions), total complications, as well as grade 1-2 and grade 3-4 complications. The top 5 complications in the total population were pneumothorax (26.63%), pleural effusion (17.22%), subcutaneous emphysema (14.31%), intra-alveolar haemorrhage (9.72%), and post-ablation syndrome (8.88%).

RFA appears to be more effective than MWA in the treatment of LC/LM, showing improved survival (OS and PFS) and comparable safety.