Comparison of radiofrequency ablation and ablative external radiotherapy for the treatment of intrahepatic malignancies: A hybrid meta-analysis

Rim, Chai Hong; Lee, Jung Sue; Kim, Soo Yeon; Seong, Jinsil

doi:10.1016/j.jhepr.2022.100594

Cited by 22 publications

(16 citation statements)

References 58 publications

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“…conducted a meta‐analysis of oncologic outcomes following RFA or SBRT for HCC, utilizing a carefully selected set of articles from global sources. The results showed no difference in OS for HCC (1‐ and 2‐year survival rates were 91.8% and 77.7% after RFA, and 89.0% and 76.0% after SBRT, respectively) 22 . This study confirms that a significant number of radiation oncologists worldwide are utilizing SBRT for the treatment of HCC, and that SBRT is efficacious in this regard.…”

Section: Discussionsupporting

confidence: 62%

Multicenter retrospective study of stereotactic body radiotherapy for patients with previously untreated initial small hepatocellular carcinoma

Doi

Nagata

Matsumoto

et al. 2023

Hepatology Research

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Aim We aimed to verify the therapeutic efficacy and safety of stereotactic body radiotherapy (SBRT) for previously untreated initial small hepatocellular carcinoma (HCC) in a multicenter, retrospective study. Methods Patients who underwent SBRT for HCC at the Japanese Society of Clinical Oncology (JCOG) member hospitals in Japan between July 2013 and December 2017 and met the following eligibility criteria were included: (1) initial HCC; (2) ≤3 nodules, ≤5 cm in diameter; (3) Child–Pugh score of A or B; and (4) unsuitability for or refusal of standard treatment. We analyzed the overall survival, recurrence‐free survival, and cumulative incidence of local recurrence rate, and adverse events directly related to SBRT. Results Seventy‐three patients with 79 lesions from 14 hospitals were analyzed. The median age was 77 years (range: 50–89 years), and the median tumor size was 23 mm (range: 6–50 mm). The median radiation dose was 40 Gy (range: 35–60 Gy) in five fractions (range: 4–8). The median follow‐up period was 45 months (range: 0–103 months). The 3‐year overall survival, recurrence‐free survival, and cumulative incidence of local recurrence rates were 69.9% (95% CI: 58.7%–81%), 57.9% (95% CI: 45.2%–70.5%), and 20.0% (95% CI: 11.2%–30.5%), respectively. Four cases (5.5%) of adverse events of grade 3 or higher were reported: three cases of grade 3 and one case of grade 4 (duodenal ulcer). No grade 5 toxicities were observed. Conclusion SBRT is a promising treatment modality, particularly for small HCCs, as they are not suitable for standard treatment.

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Section: Discussionsupporting

confidence: 62%

Multicenter retrospective study of stereotactic body radiotherapy for patients with previously untreated initial small hepatocellular carcinoma

Doi

Nagata

Matsumoto

et al. 2023

Hepatology Research

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“…Thus, SBRT exhibited advantages and excelled other treatment methods. A recent meta-analysis demonstrated that ablative external beam radiotherapy was able to yield similar treatment outcomes to RFA among patients with HCC and patients with liver metastasis and suggested that it may be a more effective treatment for tumors in locations where RFA is challenging to perform ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of stereotactic body radiotherapy for clinical outcomes of patients with liver metastasis and hepatocellular carcinoma: A retrospective study

et al. 2023

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This retrospective clinical study described the treatment efficacy and safety of stereotactic body radiotherapy (SBRT) for patients of hepatocellular carcinoma (HCC) and liver metastasis tumors. The therapeutic effect and prognosis of patients with liver cancer treated with stereotactic body radiation therapy (SBRT) at the Fudan University Shanghai Cancer Center (Shanghai, China) between July 2011 and December 2020 were retrospectively analyzed. Overall survival (OS), local control (LC) rates and progression-free survival (PFS) were evaluated using Kaplan-Meier analysis and the log-rank test. Local progression was defined as tumor growth after SBRT on dynamic computed tomography follow-up. Treatment-related toxicities were assessed according to the Common Terminology Criteria for Adverse Events version 4. A total of 36 patients with liver cancer were enrolled in the present study. The prescribed dosages (14 Gy in 3 fractions or 16 Gy in 3 fractions) were applied for SBRT treatments. The median follow-up time was 21.4 months. The median OS time was 20.4 [95% confidence interval (CI): 6.6-34.2] months, and the 2-year OS rates for the total population, HCC group and liver metastasis group were 47.5, 73.3 and 34.2%, respectively. The median PFS time was 17.3 (95% CI: 11.8-22.8) months and the 2-year PFS rates for the total population, HCC group and liver metastasis group were 36.3, 44.0 and 31.4%, respectively. The 2-year LC rates for the total population, HCC group and liver metastasis group were 83.4, 85.7 and 81.6%, respectively. The most common grade IV toxicity for the HCC group was liver function impairment (15.4%), followed by thrombocytopenia (7.7%). There were no grade III/IV radiation pneumonia or digestive discomfort. The present study aimed to explore a safe, effective and non-invasive treatment method for liver tumors. At the same time, the innovation of the present study is to find a safe and effective prescription dose of SBRT in the absence of consensus on guidelines.

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“…Schlussfolgernd ergab sich bei adäquatem Matching der BCLC-Faktoren in der Summe ein äquivalentes Überleben und eine bessere Lokalkontrolle nach SBRT im Vergleich zur RFA. Eine weitere 2023 publizierte Metaanalyse zum Vergleich der RFA und SBRT von Rim und Kollegen [328], kommt zu ähnlichen Werten für die OR hinsichtlich der lokalen Kontrolle zugunsten der SBRT (0.452 (95 % CI: 0.362-0.565, p < 0.001) und ohne einen statistisch signifikanten Unterschied beim Gesamtüberleben (1.253 (95 % CI: 0.920-1.707, p = 0.153).…”

Section: Stereotaxieunclassified

S3-Leitlinie „Diagnostik und Therapie des Hepatozellulären Karzinoms“ – Langversion 4.0

Bitzer,

Groß,

Albert

et al. 2024

Z Gastroenterol

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Comparison of radiofrequency ablation and ablative external radiotherapy for the treatment of intrahepatic malignancies: A hybrid meta-analysis

Cited by 22 publications

References 58 publications

Multicenter retrospective study of stereotactic body radiotherapy for patients with previously untreated initial small hepatocellular carcinoma

Multicenter retrospective study of stereotactic body radiotherapy for patients with previously untreated initial small hepatocellular carcinoma

Effects of stereotactic body radiotherapy for clinical outcomes of patients with liver metastasis and hepatocellular carcinoma: A retrospective study

S3-Leitlinie „Diagnostik und Therapie des Hepatozellulären Karzinoms“ – Langversion 4.0

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