SBRT as effective as Y90 for HCC, but cheaper

Use of either stereotactic body radiotherapy (SBRT) or yttrium-90 (Y90) is effective in the management of hepatocellular carcinoma (HCC), resulting in similar overall and progression-free survival, reports a study. However, Y90 is more expensive than SBRT.

A retrospective review was conducted in HCC patients treated with SBRT or Y90 radioembolization between January 2018 and January 2020 at one institution.

The authors compared demographic and treatment data among participants using χ² tests. They also compared overall and progression-free survival in different treatment groups using Kaplan-Meier curves and log-rank tests. Adjusted and unadjusted survival differences were analysed using Cox proportional hazard models.

Sixty-three patients with HCC received Y90, while 21 received SBRT. For the analysis of Medicare cost, the authors randomly chose 10 SBRT and 10 Y90 patients.

Univariate and multivariate analyses revealed no significant differences in both overall and progression-free survival between the SBRT and Y90 cohorts.

Patients on SBRT, compared with those treated with Y90, had higher American Joint Committee on Cancer staging (p=0.039), greater tumour size (4.07 vs 2.96 cm; p=0.013), and greater rates of prior liver-directed therapy (71.4 percent vs 12.7 percent; p<0.001).

In terms of cost, Y90 was significantly pricier than SBRT, with average expenses of $41,360 and $15,148, respectively.

“This study demonstrates the need for prospective studies to assess these modalities in treating HCC,” the authors said.