title: Comparison of percutaneous radiofrequency ablation and CyberKnife(®) for initial solitary hepatocellular carcinoma: A pilot study.
abstract: OBJECTIVE
  To compare therapeutic outcomes and adverse events in initial solitary hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA) and CyberKnife(®).
  
  
  METHODS
  Seventy three consecutive patients with initial solitary HCC treated with RFA (38 patients; RFA group) and CyberKnife(®) (35 patients; CK group) were enrolled in this study. Background factors were compared between the two groups. Local and intrahepatic distant recurrence control, and cumulative survival rates were compared between the two groups. These were determined using the Kaplan-Meier method, and the significance of differences was analyzed by log-rank test. The presence of more grade 3 on CTCAE ver. 4.0 early and late adverse events was investigated.
  
  
  RESULTS
  In background factors, age was significantly higher (P = 0.005) and the tumor diameter was significantly larger (P = 0.001) in the CK group. The 1-year local recurrence control rates were 97.4% and 97.1% in the RFA and CK groups, respectively (P = 0.71); the 1-year intrahepatic distant recurrence control rates were 85.6% and 86.1%, respectively (P = 0.91); and the 1-year cumulative survival rates were 100% and 95.2%, respectively (P = 0.075), showing no significant difference in any rate between the two groups. There were no late adverse event in the RFA group, but 11.4% in the CK group had late adverse events. In the CK group, the Child-Pugh score at 12 mo after treatment was significantly higher than that in the RFA group (P = 0.003) and significantly higher than the score before treatment (P = 0.034).
  
  
  CONCLUSIONS
  The occurrence of adverse events is a concern, but CyberKnife(®) treatment is likely to become an important option for local treatment of early HCC.
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Kazue
authors.initials: K
authors.lastname: Shiozawa
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ikehara
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsukiyo
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Kogame
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Yui
authors.initials: Y
authors.lastname: Kishimoto
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Makino
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukamoto
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Yoshinori Igarashi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Yasukiyo
authors.initials: Y
authors.lastname: Sumino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D018572:Disease-Free Survival; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010865:Pilot Projects; D016634:Radiosurgery / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013525:Surgical Instruments; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Adverse event; CyberKnife®; Hepatocellular carcinoma; Radiofrequency ablation; Stereotactic body radiotherapy