Propensity score-based comparison of SBRT versus thermal ablation for hepatocellular carcinoma
MO-0222
Abstract
Propensity score-based comparison of SBRT versus thermal ablation for hepatocellular carcinoma
Authors: Ciro Franzese1, Dario Poretti2, Tiziana Comito3, Riccardo Muglia2, Lorenzo Lo Faro1, Chiara Ceriani2, Vittorio Pedicini2, Ausilia Teriaca3, Ezio Lanza2, Felice D'antuono2, Luigi Solbiati4, Pietro Mancosu3, Stefano Tomatis3, Marta Scorsetti1
1Humanitas University, Humanitas Research Hospital IRCCS, Radiotherapy and Radiosurgery, Milano, Italy; 2Humanitas Research Hospital IRCCS, Unit of Interventional Radiology, Milano, Italy; 3Humanitas Research Hospital IRCCS, Radiotherapy and Radiosurgery, Milano, Italy; 4Humanitas University, Humanitas Research Hospital IRCCS, Unit of Interventional Radiology, Milano, Italy
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Purpose or Objective
Hepatocellular carcinoma (HCC) is the third cause of death worldwide. Our aim was to analyse a large monocentric group of HCC patients treated with thermal ablation (TA) or stereotactic body radiation therapy (SBRT).
Material and Methods
We included HCC treated with TA or SBRT between 2010 to 2020. Inclusion criteria for TA were: diagnosis of HCC with pathological confirmation or typical imaging features; tumors deemed inoperable; Child-Pugh < B9; tumor number ≤4; maximum diameter ≤5 cm. SBRT was considered when TA was not feasible, when tumor has not responded to transarterial embolization, in case of coagulative disorders. Primary endpoint was the comparison of local control (LC) and overall survival (OS) between the two groups.
Results
We included 576 lesions and 334 patients, 201 (60.2%) underwent TA and 133 (39.8%) underwent SBRT. Patients were more likely treated with SBRT if BCLC stage C, Child-Pugh B, HBV positive, with metabolic syndrome. Median follow-up was 19 months. 1- and 2-years LC was 78.6% and 65.7% for TA and 87.9% and 79.5% for SBRT. After application of propensity score, the superiority of SBRT was not confirmed (p = 0.235). OS at 1 and 2 years was 95.4% and 81.6% for TA and 78.6% and 48.0% for SBRT. After adjusting for propensity score, OS was comparable between the two groups (p= 0.060).
Conclusion
we confirm the efficacy and safety of TA and SBRT for the management of HCC. With the use of propensity score we demonstrated comparable results between the two treatment options.