Another TACEt.

Transarterial chemoembolization (TACE) or stereotactic body radiation (SBRT) are pitted against each other once again in this Taiwanese retrospective review of 188 patients treated for “medium-sized” (i.e., 3-8 cm) hepatocellular carcinoma (HCC) with one or the other modality. The co-primary endpoints were overall survival (OS) and in-field control (IFC). Recognizing any OS analysis in this setting is fraught with biases, they did the best they could with propensity-score matching. At a median follow-up of 17 months (26 for those living, which is an important distinction when assessing IFC), raw rates for OS 3 years after TACE versus SBRT, respectively, were 23% versus 47% and after propensity matching were 13% versus 55%. Rates of IFC at 3 years were 63% versus 73% and after propensity matching 56% versus 78%. Subset analyses indicated this benefit was largely seen in recurrent, rather than newly-diagnosed, cases. TBL: All signs point towards better local control and survival with SBRT over TACE for unresectable HCC. | Shen, Int J Radiat Oncol Biol Phy 2019