Radiofrequency Ablation Therapy versus Stereotactic Body Radiation Therapy for Naive Hepatocellular Carcinoma (≤5cm): A Retrospective Multi-Center Study

Abstract

Jing Sun,1,2,* Wengang Li,3,* Weiping He,3,* Yanping Yang,4,* Lewei Duan,5 Tingshi Su,6 Aimin Zhang,3 Tao Zhang,3 Xiaofang Zhao,7 Xiaoyun Chang,3 Xuezhang Duan1– 3 1 307 Clinical College of PLA, ANHUI Medical University, Beijing, People’s Republic of China; 2The Fifth Clinical College, ANHUI Medical University, Hefei, Anhui, People’s Republic of China; 3Department of Radiation Oncology, Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, People’s Republic of China; 4Department of Oncology, Kaifeng People’s Hospital, Kaifeng, Henan, People’s Republic of China; 5Laboratory of Epigenetics at Institutes of Biomedical Sciences, and Intelligent Medicine Institute, Fudan University, Shanghai, People’s Republic of China; 6Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China; 7Graduate School of PLA Medical College, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xuezhang Duan, 307 Clinical College of PLA, ANHUI Medical University, No. 8 East Street, Fengtai District, Beijing, People’s Republic of China, Email [email protected]: Radiofrequency ablation (RFA) is a micro-invasive treatment for early-stage HCC patients. Stereotactic body radiation therapy (SBRT) has also been proven an effective and safe treatment for HCC patients. This multi-center study is to compare the efficacy of computed tomography (CT)-guided RFA and CT-based SBRT in naïve HCC patients with tumor diameters ≤ 5 cm.Patients and Methods: This retrospective cohort study included 1001 treatment-naïve HCC patients from three hospitals or medical centers. The patients received RFA (n = 481) or SBRT (n = 520) treatment between December 2011 and May 2019. Furthermore, subgroup analyses of all patients were conducted based on Couinaud’s classification of liver segments.Results: After matching, the local control (LC) rates of the SBRT group were better than those of the RFA group (p=0.024*), which mainly referred to the patients whose tumors were located in the S7/S8 (p=0.006*). Among patients with tumors located in S1, nineteen patients (19/21) underwent SBRT. The 1-, 3- and 5-year LC rates were 100%, 87.8% and 87.8% in the SBRT group, and the 1-, 3- and 5-year OS rates were 100%, 69.8% and 69.8%, respectively. Moreover, the OS rates in S5/S6 group in RFA were higher than those in SBRT group.Conclusion: The LC rates were better in the SBRT group than in the RFA group for the patients with lesions localized in S7/S8, and SBRT could also be a therapeutic option for patients with lesions in S1. Moreover, patients with tumors located in S5/S6 were better candidates for RFA treatment than SBRT.Keywords: Stereotactic body radiation therapy, Computed tomography-guided radiofrequency, Naive hepatocellular carcinoma, Couinaud’s segmentation

Keywords

• stereotactic body radiation therapy
• computed tomography-guided radiofrequency
• naive hepatocellular carcinoma
• couinaud’s segmentation
• a propensity score matching analysis.