Journal of thoracic disease · 2025
Comparison of the efficacy and adverse events between argon-helium cryoablation and microwave ablation for non-small cell lung cancer: a propensity score matching study.
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Nan Fu-Yao, Liu Xiao-Feng, An Peng, Bian Ling-Jie, Deng Kang-Li, Huo Xiao-Sen, Zou Heng, Wang Hong-Wu, Li Lei
Аннотация
BACKGROUND: Microwave ablation (MWA) and argon-helium cryoablation (AHC) have emerged as widely utilized therapeutic modalities for non-small cell lung cancer (NSCLC) globally, prompting increasing research focus on the comparative clinical characteristics and prognostic outcomes associated with these two ablation techniques. This study aimed to explore the clinical characteristics and prognosis of MWA and AHC in the treatment of NSCLC.
METHODS: A total of 125 cases of NSCLC treated in the Beijing University of Chinese Medicine Dongzhimen Hospital were retrospectively analysed. To reduce retrospective confounding bias, propensity score matching was performed. We compared the changes in laboratory examination index before and after treatment between the two groups and the occurrence of adverse events after treatment and graded the adverse events. Kaplan-Meier analysis was employed to assess survival rates. Cox regression analysis was employed to ascertain the factors that influence the prognosis of patients.
RESULTS: After treatment, the level of systemic inflammatory response in the MWA group exhibited a statistically significant increase (P<0.01), while there was no significant change in the AHC group (P>0.05). The red blood cells and haemoglobin in both groups exhibited a statistically significant decrease (P<0.05). The incidence of bleeding events after treatment in AHC group was higher than that in the MWA group (P<0.05). There was no statistical difference in the grade of adverse events and the overall survival (OS) rate between the two groups (P>0.05). Smoking [hazard ratio (HR), 0.29; 95% confidence interval (CI): 0.09-0.93; P=0.04], chronic obstructive pulmonary disease (COPD) (HR, 0.33; 95% CI: 0.14-0.76; P=0.009) and radiotherapy (HR, 0.11; 95% CI: 0.03-0.34; P=0.001) were independent prognostic factors impacting OS.
CONCLUSIONS: MWA and AHC are both minimally invasive procedures with proven efficacy in the treatment of NSCLC with a favorable safety profile. However, AHC carries a higher risk of bleeding than MWA. It is recommended that the postoperative management of patients with smoke and COPD should be strengthened to improve their prognosis.
METHODS: A total of 125 cases of NSCLC treated in the Beijing University of Chinese Medicine Dongzhimen Hospital were retrospectively analysed. To reduce retrospective confounding bias, propensity score matching was performed. We compared the changes in laboratory examination index before and after treatment between the two groups and the occurrence of adverse events after treatment and graded the adverse events. Kaplan-Meier analysis was employed to assess survival rates. Cox regression analysis was employed to ascertain the factors that influence the prognosis of patients.
RESULTS: After treatment, the level of systemic inflammatory response in the MWA group exhibited a statistically significant increase (P<0.01), while there was no significant change in the AHC group (P>0.05). The red blood cells and haemoglobin in both groups exhibited a statistically significant decrease (P<0.05). The incidence of bleeding events after treatment in AHC group was higher than that in the MWA group (P<0.05). There was no statistical difference in the grade of adverse events and the overall survival (OS) rate between the two groups (P>0.05). Smoking [hazard ratio (HR), 0.29; 95% confidence interval (CI): 0.09-0.93; P=0.04], chronic obstructive pulmonary disease (COPD) (HR, 0.33; 95% CI: 0.14-0.76; P=0.009) and radiotherapy (HR, 0.11; 95% CI: 0.03-0.34; P=0.001) were independent prognostic factors impacting OS.
CONCLUSIONS: MWA and AHC are both minimally invasive procedures with proven efficacy in the treatment of NSCLC with a favorable safety profile. However, AHC carries a higher risk of bleeding than MWA. It is recommended that the postoperative management of patients with smoke and COPD should be strengthened to improve their prognosis.