Comparison of the efficacy and safety of thermal ablation techniques (microwave, radiofrequency and cryoablation) for lung cancer: A systematic review based on multicenter studies

This study systematically evaluated the efficacy and safety of three thermal ablation techniques—microwave ablation (MWA), radiofrequency ablation (RFA), and cryoablation (CA)—for lung cancer to support evidence-based, individualized therapy. A systematic review was conducted using multicenter data from randomized controlled trials and cohort studies retrieved from PubMed, Embase, Web of Science, and Cochrane Library. Key endpoints included local control rate, progression-free survival (PFS), overall survival (OS), and complication incidence. Quality assessment used the Cochrane risk-of-bias tool. Twelve studies were included. MWA showed the highest local control and long-term survival, especially for tumors >3 cm. RFA was effective for small tumors (≤3 cm), while CA, due to minimal collateral damage, was preferable for tumors in critical locations or ≤1.2 cm. CA had the lowest complication rate and no treatment-related mortality. Each technique showed distinct advantages depending on tumor size and location. Thermal ablation techniques provide significant clinical value in treating inoperable stage I NSCLC and oligometastatic lesions. While MWA is preferable for larger tumors, RFA and CA are optimal for small or critically located tumors. Despite promising outcomes, risks of recurrence and complications persist. Future research should focus on optimizing ablation strategies, exploring combination therapies, and validating long-term efficacy through prospective trials.