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Outcomes After Stereotactic Body Radiotherapy Or Radiofrequency Ablation For Hepatocellular Carcinoma.

D. Wahl, M. Stenmark, Y. Tao, E. Pollom, E. Caoili, T. Lawrence, M. Schipper, M. Feng
Published 2016 · Medicine

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PURPOSE Data guiding selection of nonsurgical treatment of hepatocellular carcinoma (HCC) are lacking. We therefore compared outcomes between stereotactic body radiotherapy (SBRT) and radiofrequency ablation (RFA) for HCC. PATIENTS AND METHODS From 2004 to 2012, 224 patients with inoperable, nonmetastatic HCC underwent RFA (n = 161) to 249 tumors or image-guided SBRT (n = 63) to 83 tumors. We applied inverse probability of treatment weighting to adjust for imbalances in treatment assignment. Freedom from local progression (FFLP) and toxicity were retrospectively analyzed. RESULTS RFA and SBRT groups were similar with respect to number of lesions treated per patient, type of underlying liver disease, and tumor size (median, 1.8 v 2.2 cm in maximum diameter; P = .14). However, the SBRT group had lower pretreatment Child-Pugh scores (P = .003), higher pretreatment alpha-fetoprotein levels (P = .04), and a greater number of prior liver-directed treatments (P < .001). One- and 2-year FFLP for tumors treated with RFA were 83.6% and 80.2% v 97.4% and 83.8% for SBRT. Increasing tumor size predicted for FFLP in patients treated with RFA (hazard ratio [HR], 1.54 per cm; P = .006), but not with SBRT (HR, 1.21 per cm; P = .617). For tumors ≥ 2 cm, there was decreased FFLP for RFA compared with SBRT (HR, 3.35; P = .025). Acute grade 3+ complications occurred after 11% and 5% of RFA and SBRT treatments, respectively (P = .31). Overall survival 1 and 2 years after treatment was 70% and 53% after RFA and 74% and 46% after SBRT. CONCLUSION Both RFA and SBRT are effective local treatment options for inoperable HCC. Although these data are retrospective, SBRT appears to be a reasonable first-line treatment of inoperable, larger HCC.
This paper references
10.1111/J.0006-341X.2000.01016.X
Estimation of multivariate frailty models using penalized partial likelihood.
S. Ripatti (2000)
10.1200/JCO.2012.44.1659
Sequential phase I and II trials of stereotactic body radiotherapy for locally advanced hepatocellular carcinoma.
A. Bujold (2013)
10.1097/01.sla.0000201480.65519.b8
A Prospective Randomized Trial Comparing Percutaneous Local Ablative Therapy and Partial Hepatectomy for Small Hepatocellular Carcinoma
M. Chen (2006)
10.1111/jgh.12350
Stereotactic ablative body radiotherapy for previously untreated solitary hepatocellular carcinoma
A. Takeda (2014)
10.1002/jso.21593
Preliminary result of stereotactic body radiotherapy as a local salvage treatment for inoperable hepatocellular carcinoma
Y. S. Seo. (2010)
10.1002/jso.23280
Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures
R. Cannon (2013)
10.1002/hep.21933
Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice?
T. Livraghi (2008)
10.1593/TLO.12448
Stereotactic body radiation therapy for primary and metastatic liver tumors.
Er-Qi Liu (2013)
10.1080/02841860600904862
Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries
P. Baumann (2006)
10.1186/1471-2407-10-475
Long-term effect of stereotactic body radiation therapy for primary hepatocellular carcinoma ineligible for local ablation therapy or surgical resection. Stereotactic radiotherapy for liver cancer
J. Kwon (2010)
10.1146/ANNUREV.PUBLHEALTH.21.1.121
Causal effects in clinical and epidemiological studies via potential outcomes: concepts and analytical approaches.
R. Little (2000)
10.1002/ijc.1440
Estimating the world cancer burden: Globocan 2000
D. Parkin (2001)
10.3322/caac.21208
Cancer statistics, 2014
R. Siegel (2014)
10.1016/j.radonc.2009.12.008
Systemic review of the patterns of failure following stereotactic body radiation therapy in early-stage non-small-cell lung cancer: clinical implications.
A. Chi (2010)
10.1371/journal.pone.0079854
Stereotactic Body Radiation Therapy as an Alternative Treatment for Small Hepatocellular Carcinoma
S. Yoon (2013)
10.1200/JCO.2008.19.6386
Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases.
Kyle E. Rusthoven (2009)
10.1097/01.sla.0000143301.56154.95
Radiofrequency Ablation of Small Hepatocellular Carcinoma in Cirrhotic Patients Awaiting Liver Transplantation: A Prospective Study
V. Mazzaferro (2004)
10.1200/JCO.2009.23.4450
American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer.
S. Wong (2010)
10.1016/j.ijrobp.2013.08.020
The impact of tumor size on outcomes after stereotactic body radiation therapy for medically inoperable early-stage non-small cell lung cancer.
Z. Allibhai (2013)
10.1016/j.amjsurg.2007.06.024
Radiofrequency ablation of primary and metastatic liver tumors: a critical review of the literature.
S. Garrean (2008)
10.1118/1.1851920
Use and uncertainties of mutual information for computed tomography/ magnetic resonance (CT/MR) registration post permanent implant of the prostate.
P. Roberson (2005)
10.1097/00000658-200203000-00009
Long-Term Survival and Pattern of Recurrence After Resection of Small Hepatocellular Carcinoma in Patients With Preserved Liver Function: Implications for a Strategy of Salvage Transplantation
R. Poon (2002)
10.1056/NEJM199603143341104
Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis.
V. Mazzaferro (1996)
10.1016/S0360-3016(01)02653-0
The reproducibility of organ position using active breathing control (ABC) during liver radiotherapy.
L. Dawson (2001)
10.1245/s10434-010-0976-5
Surgical Resection of High-Risk Hepatocellular Carcinoma: Patient Selection, Preoperative Considerations, and Operative Technique
M. Truty (2010)
10.1016/j.ijrobp.2008.11.026
Clinical outcomes of stereotactic body radiotherapy for small lung lesions clinically diagnosed as primary lung cancer on radiologic examination.
T. Inoue (2009)
10.1097/SLA.0000000000000234
Microwave Ablation for Hepatic Malignancies: A Multiinstitutional Analysis
R. Groeschl (2014)
10.1002/lt.20469
Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation: Assessment of efficacy at explant analysis and of safety for tumor recurrence
M. Pompili (2005)



This paper is referenced by
10.1002/mp.13002
First clinical implementation of real‐time, real anatomy tracking and radiation beam control
O. Green (2018)
10.18632/oncotarget.23428
Optimal time of tumour response evaluation and effectiveness of hypofractionated proton beam therapy for inoperable or recurrent hepatocellular carcinoma
T. Kim (2018)
10.21037/atm.2018.08.28
Local modalities for inoperable hepatocellular carcinoma: radiofrequency ablation versus stereotactic body radiotherapy.
S. H. Bae (2018)
10.21037/TCR.2016.10.67
Radiofrequency ablation and stereotactic body radiotherapy as non-surgical options for hepatocellular carcinoma
Daniel Benjamin Gans (2016)
10.1002/cncr.30008
Phase 2 study of stereotactic body radiotherapy and optional transarterial chemoembolization for solitary hepatocellular carcinoma not amenable to resection and radiofrequency ablation
A. Takeda (2016)
10.3350/cmh.2020.0038
Stereotactic body radiation therapy for small (≤5 cm) hepatocellular carcinoma not amenable to curative treatment: Results of a single-arm, phase II clinical trial
Sang Min Yoon (2020)
10.1159/000464282
Current Standard and Future Perspectives in Non-Surgical Therapy for Hepatocellular Carcinoma
T. Eggert (2017)
10.1016/j.prro.2019.07.018
Australasian Gastrointestinal Trials Group (AGITG) and Trans-Tasman Radiation Oncology Group (TROG) Guidelines for Pancreatic Stereotactic Body Radiation Therapy (SBRT).
A. Oar (2019)
10.1111/1754-9485.12754
Effectiveness and cost of radiofrequency ablation and stereotactic body radiotherapy for treatment of early‐stage hepatocellular carcinoma: An analysis of SEER‐medicare
N. Parikh (2018)
10.1016/j.amjsurg.2018.10.018
Regional therapies for the treatment of primary and metastatic hepatic tumors: A disease-based review of techniques and critical appraisal of current evidence.
B. Johnson (2019)
10.1016/j.adro.2015.12.004
Viability of Noncoplanar VMAT for liver SBRT compared with coplanar VMAT and beam orientation optimized 4π IMRT
K. Woods (2016)
10.1016/j.semradonc.2019.08.005
Transarterial Radioembolization for Hepatocellular Carcinoma and Hepatic Metastases: Clinical Aspects and Dosimetry Models.
J. Mikell (2020)
10.3892/ol.2016.4180
Treatment of liver cancer of middle and advanced stages using ultrasound-guided percutaneous ethanol injection combined with radiofrequency ablation: A clinical analysis
X. Sun (2016)
10.1016/j.radonc.2019.12.004
Comparisons between radiofrequency ablation and stereotactic body radiotherapy for liver malignancies: Meta-analyses and a systematic review.
Jeongshim Lee (2020)
10.1002/acm2.12113
Does liver resection/transplantation affect respiratory induced liver motion in patients with hepatocellular carcinoma?
Y. Hu (2017)
10.1200/JOP.2017.024604
Hepatocellular Carcinoma: A Global Disease in Need of Individualized Treatment Strategies.
N. Personeni (2017)
10.1177/1176934321994109
Exploration of Prognostic Biomarkers among Replication Factor C Family in the Hepatocellular Carcinoma
Jianxiong Deng (2021)
10.1007/978-3-030-16924-4_34
Comparative Effectiveness of SBRT
Sanjay Aneja (2019)
10.1016/j.semradonc.2018.06.005
Radiotherapy for Hepatocellular Carcinoma.
Y. Yu (2018)
10.1007/s00066-017-1204-z
Breathing-motion-compensated robotic guided stereotactic body radiation therapy
S. Stera (2017)
10.1080/2162402X.2018.1477459
Combination of radiation and interleukin 12 eradicates large orthotopic hepatocellular carcinoma through immunomodulation of tumor microenvironment
Chia-Jen Wu (2018)
10.1016/j.clon.2019.06.002
Contrasting Some Differences in Managing Advanced Unresectable Hepatocellular Carcinoma Between the East and the West.
V. Lee (2019)
10.3389/fonc.2020.01639
Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis
Yang-Xun Pan (2020)
10.1007/s12072-020-10088-0
Stereotactic body radiotherapy versus hepatic resection for hepatocellular carcinoma (≤ 5 cm): a propensity score analysis
J. Sun (2020)
10.1007/s11901-020-00559-1
Stereotactic Body Radiation Therapy (SBRT) in Hepatocellular Carcinoma
Horatio Thomas (2021)
10.1016/j.ijrobp.2016.02.024
Gastrointestinal Cancers-Changing the Standard for Rectal Cancer and Establishing a New Standard for Liver Tumors.
Smith Apisarnthanarax (2016)
10.1016/j.ijrobp.2017.12.014
Comparison of Stereotactic Body Radiation Therapy and Radiofrequency Ablation in the Treatment of Intrahepatic Metastases.
William C. Jackson (2018)
10.7759/cureus.9988
Stereotactic Body Radiation Therapy for Recurrent, Isolated Hepatocellular Carcinoma Lymph Node Metastasis With or Without Prior Liver Transplantation
Tyler Walburn (2020)
10.1016/j.radonc.2017.02.010
Clinical assessment of coiled fiducial markers as internal surrogates for hepatocellular carcinomas during gated stereotactic body radiotherapy with a real-time tumor-tracking system.
H. Hanazawa (2017)
10.1016/J.CANRAD.2019.07.159
Radiothérapie stéréotaxique hépatique : particularités cliniques et implications techniques, résultats. Quelle machine pour quelle situation ?
O. Riou (2019)
10.1155/2020/4835653
Stereotactic Body Radiotherapy as a Salvage Therapy after Incomplete Radiofrequency Ablation for Hepatocellular Carcinoma: A Retrospective Cohort Study
Yizhen Fu (2020)
10.3389/fonc.2020.00347
Stereotactic Body Radiation Therapy vs. Transarterial Chemoembolization in Inoperable Barcelona Clinic Liver Cancer Stage a Hepatocellular Carcinoma: A Retrospective, Propensity-Matched Analysis
T. Su (2020)
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