AUTHOR=Pan Yang-Xun , Fu Yi-Zhen , Hu Dan-Dan , Long Qian , Wang Jun-Cheng , Xi Mian , Liu Shi-Liang , Xu Li , Liu Meng-Zhong , Chen Min-Shan , Zhang Yao-Jun 

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

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.01639

DOI=10.3389/fonc.2020.01639

ISSN=2234-943X

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> 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, <italic>P</italic> = 0.003; and OR 0.54, 95% CI 0.37–0.80, <italic>P</italic> = 0.002, respectively]. However, SBRT reported significantly shorter 1- and 2-year OS (OR 1.52, 95% CI 1.21–1.90, <italic>P</italic> = 0.0003; and OR 1.66, 95% CI 1.38–2.01, <italic>P</italic> &lt; 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, <italic>P</italic> = 0.060; and OR 0.49, 95% CI 0.13–1.82, <italic>P</italic> = 0.290, respectively).</p><p><bold>Conclusions:</bold> 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.</p>