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Stereotactic body radiation therapy versus radiofrequency ablation in hepatocellular carcinoma: an up-date meta-analysis

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

Radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) are available locoregional curative treatments for nonsurgical Hepatocellular carcinoma (HCC) patients. We aimed to compare the clinical efficacy and safety of SBRT versus RFA for HCC.

Methods

A computerized bibliographic search was performed using PubMed, Embase, the Cochrane Library and Web of Science to identify comparative studies. The primary outcome was overall survival (OS), and the secondary outcomes were freedom from local progression (FFLP) and treatment-related complications.

Results

In total, there were 17 trials involving 22,180 patients. Patients receiving RFA showed significantly better 1-, 2- year OS (OR 0.69, 95% CI 0.50–0.96, P = 0.141,OR 0.69, 95% CI 0.53–0.89, P = 0.082), whereas SBRT resulted in significantly better 1-, 2-, 3- year FFLP (OR 2.19, 95% CI 1.44–3.34, P = 0.303; OR 1.57, 95% CI 1.12–2.19, P = 0.268; OR 2.22, 95% CI 1.70–2.90, P = 0.470). There were no significant differences for 3-, 5- year OS in both groups (OR 0.94, 95% CI 0.65–1.38, P = 0.001; OR 0.98, 95% CI 0.68–1.34, P = 0.016). The overall treatment-related complication rate did not differ significantly between the two treatment arms, while SBRT was significantly associated with Child–Pugh worsening.

Conclusions

Though SBRT has excellent FFLP, RFA yields superior short-term survival for HCC. But the discrepancy between FFLP and OS requires further investigation.

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Funding

This research was funded by National Natural Science Foundation of China, Grant No. 81530055 and Guangdong Basic and Applied Basic Research Foundation Grant No. 2020A1515010653.

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Author notes

  1. Daopeng Yang and Ke Lin have contributed equally to this paper and should be considered co-first authors.

Authors and Affiliations

  1. Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Road 2, Guangzhou, 510080, China

    Daopeng Yang, Ke Lin, Yan Wang, Xiaohua Xie, Xiaoyan Xie & Bowen Zhuang

  2. Organ Transplantation Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Daopeng Yang

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  1. Daopeng Yang
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Correspondence to Bowen Zhuang.

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Yang, D., Lin, K., Wang, Y. et al. Stereotactic body radiation therapy versus radiofrequency ablation in hepatocellular carcinoma: an up-date meta-analysis. Abdom Radiol 48, 399–410 (2023). https://doi.org/10.1007/s00261-022-03690-3

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