Study Compares RFA vs SBRT for Localized HCC

Patients with nonsurgically managed stage I or stage II hepatocellular carcinoma (HCC) have superior survival rates when they are treated with radiofrequency ablation (RFA) rather than with stereotactic body radiotherapy (SBRT), according to a study published in the Journal of Clinical Oncology.

Prospective data that could help clinicians to select the best local ablative therapy for HCC are limited, so the researchers conducted an observational study using the National Cancer Database to compare the effectiveness of RFA versus SBRT.

Propensity score–weighted and propensity score–matched analyses based on patient-, facility-, and tumor-level characteristics were used to assess overall survival in 3,684 patients with stage I HCC and 296 patients with stage II HCC . The effects of severe fibrosis/cirrhosis were evaluated using a sensitivity analysis, and exploratory analyses were used to investigate the effectiveness of the two modalities in clinically relevant subsets of patients.

Results after propensity matching revealed that 5-year overall survival was 29.8% in patients treated with RFA compared with 19.3% in patients treated with SBRT. Similar results were found after inverse probability–weighted analysis. RFA showed benefits across all subgroups, the researchers noted.

“Even though our results are limited by the biases related to the retrospective study design, we believe that, in the absence of a randomized clinical trial, our findings should be considered when recommending local ablative therapy for localized unresectable HCC,” the study’s authors concluded.

—Lauren LeBano


Rajyaguru DJ, Borgert AJ, Smith AL, et al. Radiofrequency Ablation Versus Stereotactic Body Radiotherapy for localized hepatocellular carcinoma in nonsurgically managed patients: analysis of the national cancer database. J Clin Oncol. 2018;36(6):600-608.