TY - JOUR
T1 - Comparisons between radiofrequency ablation and stereotactic body radiotherapy for liver malignancies
T2 - Meta-analyses and a systematic review
AU - Lee, Jeongshim
AU - Shin, In Soo
AU - Yoon, Won Sup
AU - Koom, Woong Sub
AU - Rim, Chai Hong
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2020/4
Y1 - 2020/4
N2 - Introduction: Radiofrequency ablation (RFA) is a standard ablative modality for small liver malignancies. Stereotactic body radiotherapy (SBRT) has emerged although yet suffers a lack of high-level evidence. We performed meta-analyses and a systematic review to integrate the literature and help in clinical decision-making. Methods: Systemic searches were performed of the PubMed, Medline, and EMBASE databases to identify controlled studies comparing RFA and SBRT. Results: Eleven studies involving 2238 patients were included. Among them, eight studies were for treating early hepatocellular carcinomas (HCCs) and three for liver metastases. Including HCCs and liver metastases studies, the pooled two-year local control (LC) rate was higher in the SBRT arm (83.8%, 95% confidence interval [CI]: 77.6–88.4) than that in the RFA arm (71.8%, 95% CI: 61.5–80.2) (p = 0.024). Among studies on liver metastases, the pooled two-year LC rate was higher in the SBRT arm (83.6% vs. 60.0%, p < 0.001). No significant difference was found between arms in HCC studies (SBRT vs. RFA: 84.5 vs. 79.5% p = 0.431). Pooled analysis of overall survival (OS) in HCC studies showed an odds ratio of 1.43 (95% CI: 1.05–1.95, p = 0.023), favoring RFA. Among the two liver metastases studies with comparative survival data, no significant difference was observed. Conclusion: LC was equivalent between RFA and SBRT for HCC and better for SBRT for the treatment of liver metastases. RFA was associated with better OS for HCC, but discrepancy between LC and OS requires further investigation, as they are local modalities having comparable efficacy.
AB - Introduction: Radiofrequency ablation (RFA) is a standard ablative modality for small liver malignancies. Stereotactic body radiotherapy (SBRT) has emerged although yet suffers a lack of high-level evidence. We performed meta-analyses and a systematic review to integrate the literature and help in clinical decision-making. Methods: Systemic searches were performed of the PubMed, Medline, and EMBASE databases to identify controlled studies comparing RFA and SBRT. Results: Eleven studies involving 2238 patients were included. Among them, eight studies were for treating early hepatocellular carcinomas (HCCs) and three for liver metastases. Including HCCs and liver metastases studies, the pooled two-year local control (LC) rate was higher in the SBRT arm (83.8%, 95% confidence interval [CI]: 77.6–88.4) than that in the RFA arm (71.8%, 95% CI: 61.5–80.2) (p = 0.024). Among studies on liver metastases, the pooled two-year LC rate was higher in the SBRT arm (83.6% vs. 60.0%, p < 0.001). No significant difference was found between arms in HCC studies (SBRT vs. RFA: 84.5 vs. 79.5% p = 0.431). Pooled analysis of overall survival (OS) in HCC studies showed an odds ratio of 1.43 (95% CI: 1.05–1.95, p = 0.023), favoring RFA. Among the two liver metastases studies with comparative survival data, no significant difference was observed. Conclusion: LC was equivalent between RFA and SBRT for HCC and better for SBRT for the treatment of liver metastases. RFA was associated with better OS for HCC, but discrepancy between LC and OS requires further investigation, as they are local modalities having comparable efficacy.
KW - Liver neoplasm
KW - Meta-analysis
KW - Radiofrequency ablation
KW - Stereotactic body radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85077593789&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2019.12.004
DO - 10.1016/j.radonc.2019.12.004
M3 - Review article
C2 - 31923711
AN - SCOPUS:85077593789
SN - 0167-8140
VL - 145
SP - 63
EP - 70
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -