title: Comparison of the Effectiveness of Radiofrequency Ablation With Stereotactic Body Radiation Therapy in Inoperable Stage I Non-Small Cell Lung Cancer: A Systemic Review and Pooled Analysis.
abstract: To performed a systematic review and pooled analysis to compare clinical outcomes of stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) for the treatment of medically inoperable stage I non-small cell lung cancer.
  
  
  
  A comprehensive literature search for published trials from 2001 to 2012 was undertaken. Pooled analyses were performed to obtain overall survival (OS) and local tumor control rates (LCRs) and adverse events. Regression analysis was conducted considering each study's proportions of stage IA and age.
  
  
  
  Thirty-one studies on SBRT (2767 patients) and 13 studies on RFA (328 patients) were eligible. The LCR (95% confidence interval) at 1, 2, 3, and 5 years for RFA was 77% (70%-85%), 48% (37%-58%), 55% (47%-62%), and 42% (30%-54%) respectively, which was significantly lower than that for SBRT: 97% (96%-98%), 92% (91%-94%), 88% (86%-90%), and 86% (85%-88%) (P<.001). These differences remained significant after correcting for stage IA and age (P<.001 at 1 year, 2 years, and 3 years; P=.04 at 5 years). The effect of RFA was not different from that of SBRT on OS (P>.05). The most frequent complication of RFA was pneumothorax, occurring in 31% of patients, whereas that for SBRT (grade ≥3) was radiation pneumonitis, occurring in 2% of patients.
  
  
  
  Compared with RFA, SBRT seems to have a higher LCR but similar OS. More studies with larger sample sizes are warranted to validate such findings.
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan; Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Nan
authors.initials: N
authors.lastname: Bi
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kerby
authors.initials: K
authors.lastname: Shedden
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Xiangpeng
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan; Department of Radiation Oncology, Indiana University, Indianapolis. Electronic address: fskong@iupui.edu.
authors.forename: Feng-Ming Spring
authors.initials: FS
authors.lastname: Kong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D017115:Catheter Ablation / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D015995:Prevalence; D011832:Radiation Injuries; D017564:Radiation Pneumonitis / Q000401:mortality / Q000517:prevention & control; D016634:Radiosurgery / Q000401:mortality* / Q000706:statistics & numerical data; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome