Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis

Frontiers in Oncology

Meng-Zhong Liu¹  Qian Long¹  Shi-Liang Liu¹  Li Xu²  Min-Shan Chen²  Yi-Zhen Fu²  Yao-Jun Zhang²  Dan-Dan Hu²  Jun-Cheng Wang²  Yang-Xun Pan³  Mian Xi⁴ 

[1] Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China;Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China;Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden;Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China;Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;

关键词: minimally invasive treatment;    meta-analysis;    hepatocellular carcinoma;    stereotactic body radiotherapy;    radiofrequency ablation;   

DOI  :  10.3389/fonc.2020.01639

来源: DOAJ

【 摘 要 】

Background: Both stereotactic body radiotherapy (SBRT) and radiofrequency ablation (RFA) are effective local treatments for hepatocellular carcinoma (HCC), but whether RFA is superior to SBRT is still controversial. Therefore, we performed a meta-analysis to compare the treatment outcomes of SBRT with RFA as curable or bridge intention.Methods: We searched online databases for studies that compared treatment outcomes for SBRT and RFA. Eligibility criteria included evaluation of local control, overall survival (OS), transplant rate, and post-transplant pathological necrosis.Results: As no randomized clinical trials met the criteria, 10 retrospective studies with a total of 2,732 patients were included. Two studies were in favor of SBRT in local control, two studies preferred RFA in OS, and others reported comparable outcomes for both. SBRT demonstrated significantly higher 1- and 3-year local control than RFA [odds ratio (OR) 0.42, 95% CI 0.24–0.74, P = 0.003; and OR 0.54, 95% CI 0.37–0.80, P = 0.002, respectively]. However, SBRT reported significantly shorter 1- and 2-year OS (OR 1.52, 95% CI 1.21–1.90, P = 0.0003; and OR 1.66, 95% CI 1.38–2.01, P < 0.00001, respectively). As bridge treatment, no significant difference was shown in transplant rate and post-transplant pathological necrosis rate (OR 0.57, 95% CI 0.32–1.03, P = 0.060; and OR 0.49, 95% CI 0.13–1.82, P = 0.290, respectively).Conclusions: This study demonstrates SBRT is able to complete a better local control for HCC than RFA, though the OS is inferior to RFA because of tumor burden or liver profiles of the enrolled studies. Well-designed, randomized, multicenter trials will be required to further investigate the conclusion.

【 授权许可】

Unknown