LAUSR

Abstract Background Stereotactic body radiation therapy (SBRT) has been shown to have high efficacy to early-stage hepatocellular carcinoma (HCC) and is expected as an alternative to radiofrequency ablation (RFA). However, how liver function is impaired by SBRT, an important factor in the therapy for HCC, is uncertain. In this study, we compared the impact of SBRT on liver function and that of RFA. Methods We retrospectively analyzed 140 patients with single small (≤3 cm) hepatocellular carcinoma treated with SBRT or RFA between January 2014 and January 2019 in Kurashiki Central Hospital. A median age was 75 years, and 101 patients were male. Liver function was assessed by the albumin-bilirubin (ALBI) score before treatment (pre-ALBI) and 3 months after treatment (post-ALBI). Patients in the SBRT group were matched at a 1:1 ratio with patients treated with RFA by using propensity score method, and post-ALBI scores were compared between the two groups. Results Among the 140 patients, 42 and 98 patients were treated with SBRT and RFA, respectively. Before matching, patients in SBRT group were significantly older than patients in RFA group (78 vs. 72.5 years, p =.038), while patients’ sex, etiology of liver diseases, tumor size, tumor location and baseline liver function (both ALBI score and Child-Turcotte-Pugh score) were similar between the two groups. In SBRT group, median pre-ALBI and post-ALBI scores were -2.40 and -2.30, respectively, and the difference was not significant (p =.336). After propensity score matching, all the baseline characteristics were well balanced, and post-ALBI scores were not significant different between SBRT and RFA groups (-2.27 vs. -2.30, p =.828). Conclusions In our study, the impact of SBRT on liver function was comparable to that of RFA. Our findings help to promote SBRT as an expecting alternative treatment for early-stage HCC. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.