Efficacy and safety of focused ultrasound versus microwave therapy for cervical ectopy: a meta-analysis

OBJECTIVES: To assess the efficacy and safety of focused ultrasound therapy (FU) and microwave therapy (MW) for cervical ectopy (CE). METHODS: We searched PubMed, EMbase, the Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journals Database (VIP), China Academic Journals Full-text Database (CNKI), and WanFang Data for randomized controlled trials (RCTs) comparing FU with MW for women with symptomatic CE from inception to 30 August 2014. Two review authors (Tang XL and Gao Z) independently screened for eligible studies according to the inclusion and exclusion criteria, extracted data and assessed risk of bias of included RCTs. Then, meta-analysis was performed using the RevMan 5.2 software. Funnel plots were used to evaluate publication bias. RESULTS: A total of 33 RCTs with 11,759 participants were included. All studies had high risk of bias. The results of meta-analysis indicated that compared to MW, FU significantly reduced the risk of vaginal bleeding (RR = 0.09, 95%CI 0.05 to 0.17, P < 0.00001) and vaginal discharge (RR = 0.10, 95%CI 0.04 to 0.24, P < 0.00001), increased the cure rate (RR = 1.10, 95%CI 1.05 to 1.15, P < 0.0001) and the total effectiveness rate (RR = 1.04, 95%CI 1.02 to 1.06, P = 0.0005), and decreased the recurrence rate (RR = 0.13, 95%CI 0.02 to 1.00, P = 0.05); however, this last difference was not statistically significant. CONCLUSION: Current available evidence suggests that FU is safer and more effective than MW for treating CE. However, some limitations will reduce the reliability of our results. Further well-designed clinical trials are needed to provide further clarification.