Shiraz University of Medical Sciences
Today, liver cancer is the 4th most common cause of death. The most effective treatment for liver cancer is surgical resection and liver transplantation, but a significant number of patients do not meet the criteria for surgery, unfortunately. Radiofrequency Ablation (RFA) and Stereotactic Body Radiation Therapy (SBRT) are two of the most well-known alternative therapies. The aim of this review is to compare these two treatments in terms of local control (LC), overall survival (OS) and side effects to make better clinical decisions for treating liver cancer patients.
This study is a systematic review based on articles, books and studies available in scientific databases such as MEDLINE, PubMed, Scopus, Google Scholar, Cochrane Library, Web of Science and EMBASE.
Ultimately, 17 studies with a total of 3760 participants (SBRT= 1366 and RFA= 2424, some patients were excluded from the studies) were included in our systematic review according to the eligibility criteria. The mean age of SBRT and RFA patients was 67.7 and 66.3 years respectively, and the follow-up of these patients was between 13 to 50.3 months. The mean LC across studies in SBRT and RFA was 93.7% and 81.86% for the first year. Also, the mean OS in SBRT and RFA was 80.3% and 81.2%, respectively.
Based on the studies, there was no significant difference between SBRT and RFA in terms of LC and OS. Although in certain cases, such as deep tumors, the proximity of the tumor to blood vessels or bile ducts, diameter more than 3 cm, tumors in the sub phrenic region or in older patients due to the inability to retain breath during RFA, SBRT is considered a better and smarter choice.