The following is a summary of “Radiofrequency Ablation Versus Stereotactic Body Radiotherapy for Recurrent Small Hepatocellular Carcinoma: A Randomized, Open-Label, Controlled Trial,” published in the December 2024 issue of Oncology by Xi et al.  

Radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) are treatments for recurrent small hepatocellular carcinoma (HCC), but their comparative effectiveness and safety need to be better established.  

Researchers conducted a prospective study to compare the efficacy and safety of SBRT and RFA in patients with recurrent small HCC.  

They randomly assigned 166 patients with recurrent single HCC ≤5 cm to receive SBRT (n=83) or RFA (n=83). The primary endpoint was local progression-free survival (LPFS), and secondary endpoints included PFS, overall survival (OS), local control rate, and safety (P=.014, HR, 0.45 [95% CI, 0.24 to 0.87]).  

The results showed that SBRT achieved significantly better LPFS than RFA (2-year LPFS rates: 92.7% [95% CI, 87.3 to 98.5] with SBRT vs. 75.8% [95% CI, 67.2 to 85.7] with RFA; HR, 0.45 [95% CI, 0.24 to 0.87]; P=.014). The median PFS was 37.6 months (95% CI, 26.0 to 49.2) for SBRT vs. 27.6 months (95% CI, 20.3 to 34.8) for RFA (HR, 0.76 [95% CI, 0.50 to 1.15]; P=.190). The 2-year OS rates were 97.6% (95% CI, 94.3 to 100.0) for SBRT and 93.9% (95% CI, 88.9 to 99.2) for RFA (HR, 0.91 [95% CI, 0.37 to 2.22]; P=.830). The incidence of AEs was similar between both groups (P=.436 and P=.715).  

They concluded that SBRT showed superior LPFS compared to RFA in treating recurrent small HCC with similar PFS, OS, and safety profiles.  

Source: ascopubs.org/doi/10.1200/JCO-24-01532