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The aim of the present study was to evaluate the benefit of chemotherapy, combined with palliative radiotherapy (PRT) and other local treatments to the metastatic sites, for patients with metastatic nasopharyngeal carcinoma (NPC) who had a performance status 0–2. We conducted a retrospective review of available data from 197 biopsy-proven NPC patients who developed metastasis after their initial definitive treatment. These patients were grouped into three categories according to the different treatment paths that were followed: the best supportive care (64 patients), chemotherapy alone (55 patients), and multimodality treatment with chemotherapy combined with PRT and other local treatments to metastatic sites (78 patients). The 2-year metastatic survival rate of patients in the multimodality treatment group was 57.7%, which was significantly better than that of the patients in both the chemotherapy alone group and the best supportive care group (32.7% and 1.6%, respectively). The independent significant factors affecting survival were the disease-free interval prior to the detection of metastatic disease, the number of metastases, the number of chemotherapy cycles and the biological effective dose of PRT. In conclusion, multimodality treatment may improve survival of select patients with recurrent NPC with distant metastases.

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Purpose: To compare the efficacy and safety of stereotactic body radiotherapy (SBRT) with radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Materials and methods: PubMed, MedLine, EMBASE, the Cochrane Library and Web of Science were searched to identify potentially eligible studies comparing the efficacy and safety of SBRT with RFA for HCC from January 1990 to May 2020. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were used to determine the effect size for overall survival (OS), local control (LC) and complications. Results: Seven studies including 7928 patients were enrolled in this meta-analysis. The results showed that SBRT was not inferior to RFA based on the pooled HR for OS (HR ¼ 1.09, 95%CI ¼ 0.78-1.52, p ¼ .62); however, the pooled HR for the LC rate showed the superiority of SBRT (HR ¼ 0.54, 95%CI ¼ 0.35-0.84, p ¼ .006). Subgroup analysis showed that the pooled HR for the LC rate favored SBRT in patients with tumors sized >2 cm (HR ¼ 0.41, 95%CI ¼ 0.23-0.74, p ¼ .003), but no significant difference was observed in patients with tumors sized 2 cm (HR ¼ 0.56, 95%CI ¼ 0.25-1.28, p ¼ .17). In addition, no significant differences in the incidence of late severe complications were observed between the SBRT and RFA groups (OR ¼ 1.01, 95%CI ¼ 0.59-1.73, p ¼ .97). Conclusions: Based on the current data, we concluded that SBRT was well tolerated with an OS equivalent to that with RFA; SBRT was superior to RFA in terms of LC of HCC, especially in those with tumors sized >2 cm.