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

• Published in: Cancer research and treatment Vol. 54; no. 3; pp. 850 - 859
• Main Authors: Yu, Jesang, Kim, Dong Hwan, Lee, Jungbok, Shin, Yong Moon, Kim, Jong Hoon, Yoon, Sang Min, Jung, Jinhong, Kim, Jin Cheon, Yu, Chang Sik, Lim, Seok-Byung, Park, In Ja, Kim, Tae Won, Hong, Yong Sang, Kim, Sun Young, Kim, Jeong Eun, Park, Jin-Hong, Kim, So Yeon
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.07.2022; 대한암학회
• Subjects: Original; 의학일반; Radiofrequency ablation; Colorectal cancer liver metastases; Prognosis; Stereotactic body radiation therapy
• ISSN: 1598-2998; 2005-9256
• DOI: 10.4143/crt.2021.674

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. 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). 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). 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.