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KMID : 0939920220540030850
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대한암학회지
2022 Volume.54 No. 3 p.850 ~ p.859
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Radiofrequency Ablation versus Stereotactic Body Radiation Therapy in the Treatment of Colorectal Cancer Liver Metastases
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Yu Je-Sang
Kim Dong-Hwan
Lee Jung-Bok
Shin Yong-Moon
Kim Jong-Hoon
Yoon Sang-Min
Jung Jin-Hong
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
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Abstract
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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 (hazard ratio, 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.
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KEYWORD
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Radiofrequency ablation, Stereotactic body radiation therapy, Colorectal cancer liver metastases, Prognosis
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