Local modalities for inoperable hepatocellular carcinoma: radiofrequency ablation versus stereotactic body radiotherapy

Hepatocellular carcinoma (HCC) is one of the most common malignancies and a leading cause of cancer deaths in the worldwide (1). Liver transplantation is the only treatment option to cure both HCC and hepatic dysfunction simultaneously; however, because of limited availability of donor organs, transplantation is applied in a minority of patients who meet the Milan criteria (2). Hence, surgical resection is recommended as the first treatment option, although less than 30% of HCC patients are eligible at diagnosis owing to functional status, comorbidities, extent of disease, or hepatic decompensation in the setting of underlying liver disease (3). For unresectable HCC, patients are treated with various local ablative modalities, including radiofrequency ablation (RFA), stereotactic body radiotherapy (SBRT), microwave ablation, cryoablation, and percutaneous ethanol injection.