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Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis
Background: 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 wi...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658324/ https://www.ncbi.nlm.nih.gov/pubmed/33194569 http://dx.doi.org/10.3389/fonc.2020.01639 |
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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 |
author_facet | 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 |
author_sort | Pan, Yang-Xun |
collection | PubMed |
description | Background: 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. Methods: 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. Results: 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, P = 0.003; and OR 0.54, 95% CI 0.37–0.80, P = 0.002, respectively]. However, SBRT reported significantly shorter 1- and 2-year OS (OR 1.52, 95% CI 1.21–1.90, P = 0.0003; and OR 1.66, 95% CI 1.38–2.01, P < 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, P = 0.060; and OR 0.49, 95% CI 0.13–1.82, P = 0.290, respectively). Conclusions: 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. |
format | Online Article Text |
id | pubmed-7658324 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76583242020-11-13 Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis 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 Front Oncol Oncology Background: 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. Methods: 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. Results: 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, P = 0.003; and OR 0.54, 95% CI 0.37–0.80, P = 0.002, respectively]. However, SBRT reported significantly shorter 1- and 2-year OS (OR 1.52, 95% CI 1.21–1.90, P = 0.0003; and OR 1.66, 95% CI 1.38–2.01, P < 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, P = 0.060; and OR 0.49, 95% CI 0.13–1.82, P = 0.290, respectively). Conclusions: 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. Frontiers Media S.A. 2020-10-29 /pmc/articles/PMC7658324/ /pubmed/33194569 http://dx.doi.org/10.3389/fonc.2020.01639 Text en Copyright © 2020 Pan, Fu, Hu, Long, Wang, Xi, Liu, Xu, Liu, Chen and Zhang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology 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 Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis |
title | Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis |
title_full | Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis |
title_fullStr | Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis |
title_full_unstemmed | Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis |
title_short | Stereotactic Body Radiotherapy vs. Radiofrequency Ablation in the Treatment of Hepatocellular Carcinoma: A Meta-Analysis |
title_sort | stereotactic body radiotherapy vs. radiofrequency ablation in the treatment of hepatocellular carcinoma: a meta-analysis |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658324/ https://www.ncbi.nlm.nih.gov/pubmed/33194569 http://dx.doi.org/10.3389/fonc.2020.01639 |
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