Stereotactic body radiation therapy versus radiofrequency ablation in patients with small hepatocellular carcinoma: a systematic review and meta-analysis.

Hepatobiliary Surg Nutr

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Published: October 2021

AI Article Synopsis

  • This study compared clinical outcomes and toxicity of small hepatocellular carcinoma (HCC) patients treated with stereotactic body radiation therapy (SBRT) vs. radiofrequency ablation (RFA).
  • The analysis included data from five studies with 4,814 patients, showing that SBRT had a significantly lower overall survival (OS) at 2 years but a higher freedom from local progression (FFLP) rate compared to RFA.
  • Despite the contradictory results for OS and FFLP, local and liver toxicities were similar for both treatments, indicating a need for future research with standardized treatment protocols.

Article Abstract

Background: This study aimed to compare the clinical outcomes and toxicity between small hepatocellular carcinoma (HCC) patients treated with stereotactic body radiation therapy (SBRT) and those treated with radiofrequency ablation (RFA).

Methods: We searched databases for relevant clinical studies. The primary outcomes of interest were overall survival (OS) at 1 and 2 years, freedom from local progression (FFLP) rate at 2 years, and complications.

Results: Five cohorts from 5 retrospective studies and 4,814 patients with HCC were included. Pooled OS at 2 years was significantly lower for SBRT than for RFA [odds ratio (OR): 0.63; 95% confidence interval (CI): 0.51-0.79; P<0.0001], but the pooled FFLP rate at 2 years was higher for SBRT than for RFA (OR: 1.66; 95% CI: 1.05-2.61; P=0.03). In addition, there was no significant difference in the local and liver toxicities of the two treatments. The contradictory conclusion between the OS and FFLP outcome may be attributed to the difference in radiological dose and location, but there were no uniform criteria to illustrate the radiological dose and location in the included studies.

Conclusions: SBRT had a higher local control ratio but poorer prognosis than RFA in patients with small HCC. The local toxicity was comparable in both treatments. Further trials should be designed with uniform standards for SBRT and RFA treatments.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8527428PMC
http://dx.doi.org/10.21037/hbsn.2020.03.15DOI Listing

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