Stereotactic body radiation therapy and radiofrequency ablation in patients with hepatocellular carcinoma: not a rival but a partner for the cure

Kim, Nalee; Seong, Jinsil

doi:10.21037/hbsn-22-330

Cited by 1 publication

(2 citation statements)

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“…The treatment decision to combine radiotherapy and ablation should be individualized. From a clinical practice perspective, tumors close to blood vessels or located in subphrenic area jeopardized local control of RFA 12 . The SBRT and SIRT were unaffected by the position of tumor, therefore, radiotherapy may still help improve local control of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Hong et al conducted a meta-analysis comparing SBRT vs. RFA in patients with small HCC and they reported that radiotherapy provided a higher local control ratio but a poorer prognosis than RFA 11 . Given that SBRT could serve as the supplementary therapeutic strategy when the lesion was attached to a vessel or located at subphrenic region, more and more researchers raised the point that these two types of treatment were not rivals but partners for the cure 12 . Considering the probability of incomplete RFA, the new strategy based on RFA plus radiotherapy was proposed by many researchers.…”

Section: Introductionmentioning

confidence: 99%

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

Guo,

Chen,

Wan

et al. 2024

Sci Rep

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Recently, the efficacy of two low-invasive treatments, ablation, and radiotherapy, has been fully compared for the patients with the early-stage hepatocellular carcinoma (HCC). However, the comparison between radiotherapy plus ablation and ablation alone has been less frequently reported. Data from the Surveillance, Epidemiology, and End Results (SEER) database were searched for early-stage HCC patients treated with ablation plus radiotherapy or ablation alone. The outcome measures were overall survival (OS) and cancer-specific survival (CSS). The propensity score matching (PSM) was used to reduce selection bias. We included 240 and 6619 patients in the radiotherapy plus ablation group and ablation group before the PSM. After PSM, 240 pairs of patients were included. The median OS (mOS) and median CSS (mCSS) of patients receiving ablation alone were longer than that of receiving radiotherapy plus ablation (mOS: 47 vs. 34 months, P = 0.019; mCSS: 77 vs. 40 months, P = 0.018, after PSM) before and after PSM. The multivariate analysis indicated that radiotherapy plus ablation independent risk factor for OS and CSS before PSM, but the significance disappeared after PSM. The detailed subgroup analyses indicated ablation alone brought more benefit in very early-stage HCC and older patients. In addition, we found different types of radiotherapy might lead to different outcomes when combined with ablation. In conclusion, ablation alone is noninferior to radiotherapy plus ablation in patients with early-stage HCC. The additional radiation prior to ablation may bring survival benefits in the patients with higher tumor stage. However, due to the risk of selection bias in that study, the results should be interpreted cautiously.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%