Cancer Res Treat.  2022 Jul;54(3):850-859. 10.4143/crt.2021.674.

Radiofrequency Ablation versus Stereotactic Body Radiation Therapy in the Treatment of Colorectal Cancer Liver Metastases

• Yu J
• Kim DH
• Lee J
• Shin YM
• Kim JH
• Yoon SM
• Jung J
• Kim JC
• Yu CS
• Lim SB
• Park IJ
• Kim TW
• Hong YS
• Kim SY
• Kim JE
• Park Jh
• Kim SY

• KMID: 2531331
• DOI: http://doi.org/10.4143/crt.2021.674

Abstract

Purpose
This study aimed to compare the treatment outcomes of radiofrequency ablation (RFA) and stereotactic body radiation therapy (SBRT) for colorectal cancer liver metastases (CRLM) and to determine the favorable treatment modality according to tumor characteristics.
Materials and Methods
We retrospectively analyzed the records of 222 colorectal cancer patients with 330 CRLM who underwent RFA (268 tumors in 178 patients) or SBRT (62 tumors in 44 patients) between 2007 and 2014. Kaplan–Meier method and Cox models were used by adjusting with inverse probability of treatment weighting (IPTW).
Results
The median follow-up duration was 30.5 months. The median tumor size was significantly smaller in the RFA group than in the SBRT group (1.5 cm vs 2.3 cm, p<0.001). In IPTW-adjusted analysis, difference in treatment modality was not associated with significant differences in 1-year and 3-year recurrence-free survival (35% vs 43%, 22% vs 23%; p=0.198), overall survival (96% vs 91%, 58% vs 56%; p=0.508), and freedom from local progression (FFLP; 90% vs 72%, 78% vs 60%; p=0.106). Significant interaction effect between the treatment modality and tumor size was observed for FFLP (p=0.001). In IPTW-adjusted subgroup analysis of patients with tumor size >2 cm, the SBRT group had a higher FFLP compared with the RFA group (HR, 0.153; p<0.001).
Conclusion
SBRT and RFA showed similar local control in the treatment of patients with CRLM. Tumor size was an independent prognostic factor for local control and SBRT may be preferred for larger tumors.

Keyword

Radiofrequency ablation; Stereotactic body radiation therapy; Colorectal cancer liver metastases; Prognosis

Figure

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  Fig. 1 Flow diagram of patient selection. RFA, radiofrequency ablation; SBRT, stereotactic body radiation therapy.

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  Fig. 2 Inverse probability of treatment weighting–adjusted freedom from local progression according to treatment modality. RFA, radiofrequency ablation; SBRT, stereotactic body radiation therapy.

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  Fig. 3 FFLP according to treatment modality stratified by tumor size. Y-axis is the ratio of the HR of RFA to SBRT. FFLP, freedom from local progression; HR, hazard ratio; RFA, radiofrequency ablation; SBRT, stereotactic body radiation therapy.

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  Fig. 4 Kaplan-Meier curves of recurrence-free survival after inverse probability of treatment weighting adjustment according to treatment modality. RFA, radiofrequency ablation; SBRT, stereotactic body radiation therapy.

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  Fig. 5 Kaplan-Meier curves of overall survival after inverse probability of treatment weighting adjustment according to treatment modality. RFA, radiofrequency ablation; SBRT, stereotactic body radiation therapy.

Reference

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