Jiawei Hong1,2, Linping Cao1,2, Haiyang Xie1,2,3, Yuanxing Liu1,2,3, Jun Yu1,2,3, Shusen Zheng1,2,3. 1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. 2. Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou, China. 3. The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China.
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. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
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. 2021 Hepatobiliary Surgery and Nutrition. All rights reserved.
Authors: Louis Potters; Brian Kavanagh; James M Galvin; James M Hevezi; Nora A Janjan; David A Larson; Minesh P Mehta; Samuel Ryu; Michael Steinberg; Robert Timmerman; James S Welsh; Seth A Rosenthal Journal: Int J Radiat Oncol Biol Phys Date: 2010-02-01 Impact factor: 7.038
Authors: D F Stroup; J A Berlin; S C Morton; I Olkin; G D Williamson; D Rennie; D Moher; B J Becker; T A Sipe; S B Thacker Journal: JAMA Date: 2000-04-19 Impact factor: 56.272