Open AccessRadiofrequency ablation versus stereotactic body radiotherapy for small hepatocellular carcinoma: a Markov model‐based analysis
Author(s) -
Seo YoungSeok,
Kim MiSook,
Yoo HyungJun,
Jang Won Il,
Paik Eun Kyung,
Han Chul Ju,
Lee ByungHee
Publication year - 2016
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.893
Subject(s) - medicine , radiofrequency ablation , hepatocellular carcinoma , radiosurgery , cohort , radiology , confidence interval , nuclear medicine , ablation , radiation therapy
The aim of this study is to compare radiofrequency ablation ( RFA ) with stereotactic body radiotherapy ( SBRT ) for hepatocellular carcinomas ( HCC ) smaller than 3 cm. A Markov cohort model was developed to simulate a cohort of patients aged 60–65 years with small HCC s who had undergone either RFA or SBRT and were followed up over their remaining life expectancy. The inclusion criteria were: (1) HCC ≤3 cm in diameter with ≤ 3 nodules; (2) absence of extrahepatic metastasis or portal/hepatic vein invasion; (3) Child‐Pugh Class A or B. Twenty thousand virtual patients were randomly assigned to undergo RFA or SBRT . Predicted life expectancy was 6.452 and 6.371 years in the RFA and SBRT groups, respectively. The probability distributions of the expected overall survival were nearly identical. The 95% confidence intervals were 6.25–6.66 and 6.17–6.58 years for RFA and SBRT , respectively. The difference between RFA and SBRT was insignificant ( P = 0.2884). Two‐way sensitivity analysis demonstrated that if the tumor is 2–3 cm, SBRT is the preferred treatment option. Our Markov model has shown that expected overall survival of SBRT is nearly identical to RFA in HCC s smaller than 3 cm, but SBRT may have an advantage for tumors 2 cm and larger. A randomized trial is required to confirm these findings.