High Intensity Focused Ultrasound for Myoma of Uterus Fibroid: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Yanzhi ^1,2,3 ,  YANG Lan ^1,2 , ZHANG Shanhu ^2,3 , QIU Jie ^1,2

1. Maternal and Child Care Service Hospital of Gansu Province, Lanzhou 730000, China;2. Maternal, Child and Adolescent Health Institute, School of Public Health, Lanzhou University, Lanzhou 730000, China;3. Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

YANG Lan, Email: yanglan0608@126.com

Keywords：

High intensity focused ultrasound; Myoma of uterus fibroid; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20130209

Video：

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Objective 　To systematically review the effectiveness and safety of high intensity focused ultrasound (HIFU) for myoma of uterus fibroid.
Methods 　Such databases as PubMed, EMbase, Web of Science, The Cochrane Library (Issue 10, 2012), CBM, CNKI, and WanFang Data were electronically searched from inception to November 2012 for randomized controlled trials on HIFU for myoma of uterus fibroid. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.0 software, and the quality levels of evidence were graded using GRADEpro 3.2 software.
Results 　A total of 6 trials were included, involving 643 patients. The results of meta-analysis showed that, HIFU was similar to surgery in complete and partial fibroid ablation, with no significant difference; HIFU and radiofrequency were different in complete and partial fibroid ablation, with significant differences; and HIFU was superior to mifepristone in complete fibroid ablation, with a significant difference.
Conclusion 　HIFU is an alternative, non-invasive, safe and effective treatment for myoma of uterus fibroid.

Citation： ZHOU Yanzhi,YANG Lan,ZHANG Shanhu,QIU Jie. High Intensity Focused Ultrasound for Myoma of Uterus Fibroid: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(10): 1219-1223. doi: 10.7507/1672-2531.20130209 Copy

1.	Hutchins FL. Abdominal myomectomy as a treatment for symptomatic uterine fibroids. Obstetrics and Gynecology Clinics of North America, 1995, 22(4): 781-789.
2.	冷金花, 张震宇, 段华, 等. 子宫肌瘤诊治的热点问题. 现代妇产科进展, 2007, 16(5): 321-333.
3.	江娜, 朱雪琼, 陈文兵. 不同剂量米非司酮治疗子宫肌瘤106例临床观察. 中国妇幼保健, 2010, 25(34): 5128-5131.
4.	Davies A, Hart R, Magos A, et al. Hysterectomy: surgical route and complications. Eur J Obstet Gynecol Reprod Biol, 2002, 04(2): 148-151.
5.	Kim Y, Bae DS, Kim BG, et al. A faster nonsurgical solution: very large fibroid tumors yielded to a new ablation strategy. Am J Obstet Gynecol, 2011, 205(3): 292-295.
6.	Walker WJ, Pelage JP. Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG, 2002, 109(11): 1262-1272.
7.	孟欣. 高强度聚焦超声与射频联合治疗富血供的子宫肌瘤的临床研究. 第四军医大学, 2010.
8.	Ghezzi F, Cromi A, Bergamini V, et al. Midterm outcome of radiofrequency thermal ablation for symptomatic uterine myomas. Surg Endosc, 2007, 21(11): 2081-2085.
9.	Nevadunsky NS, Bachmann GA, Nosher J, et al. Women’s decision-making determinants in choosing uterine artery embolization for symptomatic fibroids. J Reprod Med, 2001, 46(10): 870-874.
10.	秦娟. 超声消融子宫肌瘤对机体创伤及肿瘤局部效应安全性研究. 重庆医科大学, 2012.
11.	柯庆华, 刘敏, 陈朝晖, 等. 高强度聚焦超声治疗子宫肌瘤与手术治疗的对比分析. 中国误诊学杂志, 2007, 7(10): 2239-2240.
12.	Meng X, He G, Zhang J, et al. A comparative study of fibroid ablation rates using radio frequency or high-intensity focused ultrasound. Cardiovasc Intervent Radiol, 2010, 33(4): 794-799.
13.	李华林, 张丰明, 李群. 高强度聚焦超声与射频治疗子宫肌瘤术中声像研究. 中国中西医结合影像学杂志, 2003, 1(3): 152-153.
14.	李春栾. 高强度聚焦超声联合米非司酮治疗子宫肌瘤疗效观察. 河北医药, 2008, 30(4): 460-461.
15.	蒋秋燕, 唐乾利, 伍业冬, 等. 子宫肌瘤高强度聚焦超声治疗的临床研究. 广西医科大学学报, 2002, 19(3): 344-345.
16.	Stephen JS, Malone DE. Sedation and analgesia in adult patients: evaluation of a staged-dose system based on body weight for use in abdominal interventional radiology. Radiology, 2000, 216(4): 653–659.
17.	朱丽, 陈文直, 陈锦云. 咪唑安定-芬太尼镇静镇痛在高强度聚焦超声子宫肌瘤中的应用研究. 重庆医科大学学报, 2009, 34(11): 1556-1558.
18.	Fennessy FM, Tempany CM, Mcdannold NJ, et al. Uterine leiomyomas: MR imaging-guided focused ultrasound surgery—results of different treatment protocols. Radiology, 2007, 243(3): 885-893.

1. 　Hutchins FL. Abdominal myomectomy as a treatment for symptomatic uterine fibroids. Obstetrics and Gynecology Clinics of North America, 1995, 22(4): 781-789.
2. 冷金花, 张震宇, 段华, 等. 子宫肌瘤诊治的热点问题. 现代妇产科进展, 2007, 16(5): 321-333.
3. 江娜, 朱雪琼, 陈文兵. 不同剂量米非司酮治疗子宫肌瘤106例临床观察. 中国妇幼保健, 2010, 25(34): 5128-5131.
4. Davies A, Hart R, Magos A, et al. Hysterectomy: surgical route and complications. Eur J Obstet Gynecol Reprod Biol, 2002, 04(2): 148-151.
5. Kim Y, Bae DS, Kim BG, et al. A faster nonsurgical solution: very large fibroid tumors yielded to a new ablation strategy. Am J Obstet Gynecol, 2011, 205(3): 292-295.
6. Walker WJ, Pelage JP. Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG, 2002, 109(11): 1262-1272.
7. 孟欣. 高强度聚焦超声与射频联合治疗富血供的子宫肌瘤的临床研究. 第四军医大学, 2010.
8. Ghezzi F, Cromi A, Bergamini V, et al. Midterm outcome of radiofrequency thermal ablation for symptomatic uterine myomas. Surg Endosc, 2007, 21(11): 2081-2085.
9. Nevadunsky NS, Bachmann GA, Nosher J, et al. Women’s decision-making determinants in choosing uterine artery embolization for symptomatic fibroids. J Reprod Med, 2001, 46(10): 870-874.
10. 秦娟. 超声消融子宫肌瘤对机体创伤及肿瘤局部效应安全性研究. 重庆医科大学, 2012.
11. 柯庆华, 刘敏, 陈朝晖, 等. 高强度聚焦超声治疗子宫肌瘤与手术治疗的对比分析. 中国误诊学杂志, 2007, 7(10): 2239-2240.
12. Meng X, He G, Zhang J, et al. A comparative study of fibroid ablation rates using radio frequency or high-intensity focused ultrasound. Cardiovasc Intervent Radiol, 2010, 33(4): 794-799.
13. 李华林, 张丰明, 李群. 高强度聚焦超声与射频治疗子宫肌瘤术中声像研究. 中国中西医结合影像学杂志, 2003, 1(3): 152-153.
14. 李春栾. 高强度聚焦超声联合米非司酮治疗子宫肌瘤疗效观察. 河北医药, 2008, 30(4): 460-461.
15. 蒋秋燕, 唐乾利, 伍业冬, 等. 子宫肌瘤高强度聚焦超声治疗的临床研究. 广西医科大学学报, 2002, 19(3): 344-345.
16. Stephen JS, Malone DE. Sedation and analgesia in adult patients: evaluation of a staged-dose system based on body weight for use in abdominal interventional radiology. Radiology, 2000, 216(4): 653–659.
17. 朱丽, 陈文直, 陈锦云. 咪唑安定-芬太尼镇静镇痛在高强度聚焦超声子宫肌瘤中的应用研究. 重庆医科大学学报, 2009, 34(11): 1556-1558.
18. Fennessy FM, Tempany CM, Mcdannold NJ, et al. Uterine leiomyomas: MR imaging-guided focused ultrasound surgery—results of different treatment protocols. Radiology, 2007, 243(3): 885-893.

Chinese Journal of Evidence-Based Medicine

High Intensity Focused Ultrasound for Myoma of Uterus Fibroid: A Meta-Analysis

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