This was a very well done study, with the limitations that the authors acknowledged. We need now to look at SBRT on a larger scale, to see if it is feasible outside the realm of one institution.— Ghassan K. Abou-Alfa, MD
Ghassan K. Abou-Alfa, MD, a liver and biliary cancer specialist at Memorial Sloan Kettering Cancer Center, New York, commented on the study for The ASCO Post. While acknowledging that a single-institution study of 30 patients is naturally “limited in scope,” he said the outcome of the study of transarterial chemoembolization (TACE) and stereotactic body radiation therapy (SBRT) was welcomed by the liver transplant community.
“The conclusion was that SBRT, which is a much newer approach than TACE, is equally effective,” he said. Patients underwent transplant in almost equal numbers post either approach, he noted, “but at the same time, there was less toxicity with SBRT, no need for hospitalization, and better quality of life.”
“TACE may not always be a pleasant experience for patients, who can experience fevers, abdominal pain, and other side effects. SBRT is without these immediate consequences, and it is done in a highly controlled manner so that patients can be released home without problems,” Dr. Abou-Alfa pointed out. “SBRT can be less operator-dependent than TACE, and this not only affects complications and quality of life, but can also bring a component of reproducibility.”
While TACE is a standard of care “tested and proven,” he concluded, the use of SBRT instead is a “thought-provoking” concept that deserves further evaluation. “This was a very well done study, with the limitations that the authors acknowledged. We need now to look at SBRT on a larger scale, to see if it is feasible outside the realm of one institution.” ■
Disclosure: Dr. Abou-Alfa reported no potential conflicts of interest.
For hepatocellular carcinoma patients awaiting a liver transplant, locoregional treatment as a “bridge” is a standard strategy for reducing tumor progression. The most common approach is transarterial chemoembolization, but a study from a large-volume liver transplant center questions whether it...