인제의대 / 신황식, 이세환, 전백규*
Background/aim: Stereotactic body radiotherapy (SBRT) may be an alternative treatment for patients with small (≤3 cm) hepatocellular carcinomas (HCCs) who were not indicated for resection or local ablation therapy. This study compared the therapeutic effects of radiofrequency ablation (RFA) and SBRT in patients with small (≤3 cm) HCCs.
Methods: Data of HCC patients who underwent SBRT or RFA as an initial treatment at four tertiary referral hospitals between March 2011 and February 2017 were reviewed. The patient inclusion criteria were a single nodule measuring ≤3 cm in size and not suitable for resection.
Results: SBRT and RFA were performed for 72 (SBRT group) and 134 (RFA group) patients, respectively. The 1-, 3-, and 5-year overall survival (OS) rates were 97.0%, 80.3%, and 80.3%, respectively, in the SBRT group compared with 98.5%, 83.9%, and 80.8%, respectively, in the RFA group, with no significant differences between the groups (P = 0.81). The estimated five-year local control (LC) rate was 68.1% in the SBRT group and 73.1% in the RFA group (P = 0.81). In the SBRT group analysis, both SBRT alone (n = 34) and SBRT combined with transarterial chemoembolization (n = 38) showed no difference with RFA in OS (P = 0.72 and P = 0.90) or LC rate (P = 0.95 and P = 0.68), respectively.
Conclusion: SBRT is an effective and safe treatment method for small HCCs, with survival and tumor recurrence rates similar to those of RFA.
Hwang Sik Shin 1, Sae Hwan Lee 2, Baek Gyu Jun 3, Hong Soo Kim 2, Seong Hee Kang 3, Ji Young Park 3, Soo In Choi 3, Gab Jin Cheon 4, Young Don Kim 4, Jeong-Ju Yoo 5, Sang Gyune Kim 5, Young Seok Kim 5, Soung Won Jeong 6, Jae Young Jang 6, Ki Tae Suk 7, Dong Joon Kim 7, In Young Jo 8, Yong Kyun Won 8
1Department of Family Medicine, Soonchunhyang University College of Medicine Cheonan Hospital, Cheonan.
2Department of Internal Medicine, Soonchunhyang University College of Medicine Cheonan Hospital, Cheonan.
3Depart- ment of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul.
4Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung.
5Department of Internal Medicine, Soonchunhyang University College of Medicine Bucheon Hospital, Bucheon.
6Department of Internal Medicine, Soonchunhyang University College of Medicine Seoul Hospital, Seoul.
7Department of Internal Medicine Hallym University College of Medicine, Chuncheon.
8Department of Radiation Oncology, Soonchunhyang University College of Medicine Cheonan Hospital, Cheonan, South Korea.
후향적 연구이기는 하지만 HCC 진단 후 첫치료로써 RFA와 SBRT를 비교하여 5년 치료성적에 차이가 없음을 보여준 흥미로운 연구입니다.