Randomized trial of radiofrequency ablation versus stereotactic body radiotherapy for recurrent small hepatocellular carcinoma

A randomized trial at Sun Yat-sen University Cancer Center (Guangzhou, China) compared radiofrequency ablation (RFA) versus stereotactic body radiotherapy (SBRT) for recurrent small hepatocellular carcinoma (HCC, single lesion ≤ 5 cm). Primary end point was local progression-free survival (LPFS). Two-year LPFS rates were 92.7% with SBRT versus 75.8% with RFA (HR 0.45; p= 0.014). Median progression-free survival was 37.6 months with SBRT versus 27.6 months with RFA (p=0.190), and two-year overall survival rates were 97.6% with SBRT versus 93.9% with RFA (p=0,830). The incidences of both acute and late adverse events were comparable between the groups. The authors conclude that among patients with single recurrent HCC ≤ 5 cm, SBRT resulted in better LPFS than RFA, whereas PFS, OS, and safety were comparable between the two treatments.