Safety and efficacy study: Short-term application of radiofrequency ablation and stereotactic body radiotherapy for Barcelona Clinical Liver Cancer stage 0–B1 hepatocellular carcinoma

Abstract

Aim To evaluate the safety and efficacy of the administration of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) in the short term to the same patients in Barcelona Clinical Liver Cancer (BCLC) stages 0–B1. Methods From April 2014 to June 2019, we retrospectively reviewed BCLC stage 0–B1 patients with fresh hepatocellular carcinoma (HCC) lesions that were repeatedly treated by RFA (control group, n = 72), and by RFA and subsequent SBRT (case group, n = 26). Propensity score matching (PSM) was performed to reduce the selection bias between two groups. Recurrence, survival, Child–Pugh scores and short-term side effects (fever, bleeding, skin change, abdominal pain and fatigue) were recorded and analyzed. Results After PSM, 21 patients remained in each group. Seventeen and 20 patients in the case and control groups experienced recurrence. For these patients, the median times to progression and follow-up were 10.7 and 35.8 months, respectively. After PSM, the 1-year progression-free survival rate in case and control groups were 66.7% and 52.4%, respectively (P = 0.313). The inter-group overall survival (OS) was comparable (3 and 5-year OS rates in case groups were 87.3% and 74.8%, while rates in control groups were 73.7% and 46.3%, respectively; P = 0.090). The short-term side effects were mild, and the incidence showed no inter-group difference. The 1-year rates of the Child–Pugh score deterioration of ≥2 in case and control groups were 23.8% and 33.3% (P > 0.05), respectively. Conclusion The short-term administration of RFA and SBRT to the same BCLC stage 0–B1 patients may be feasible and effective because of their good prognosis and safety.

Ablation alone is noninferior to radiotherapy plus ablation in the patients with early-stage hepatocellular carcinoma: a population-based study

“…As the technique of radiotherapy evolves, the role of radiotherapy in the treatment of hepatocellular cancer has been explored. Previous studies have demonstrated the safety of SBRT plus ablation in early and even intermediate‐stage HCC 13 – 15 , therefore, we analyzed data from the publicly accessible SEER database to compare the efficacy of radiotherapy plus ablation and ablation alone in early-stage HCC.…”

“…5 A). However, a retrospective study reported that the safety and efficacy of SBRT plus ablation were similar to ablation alone in HCC patients at the stage of 0-B1 13 , therefore, we speculated that “beam radiation” may include other kinds of radiation therapy whose efficacy are worse than SBRT. Moreover, we needed to cleared that part of patients treated with combination therapy might use radiotherapy as a salvage treatment which might lead to selection bias in the population between two groups.…”

“…Considering the probability of incomplete RFA, the new strategy based on RFA plus radiotherapy was proposed by many researchers. They found RFA plus radiotherapy was safe and tolerated for patients 13 – 15 , meanwhile, patients who received RFA plus radiotherapy may have a lower local disease progression rate and better progression-free survival (PFS) 16 .…”