Hepatocellular Carcinoma · Radiation · Salvage / Recurrent

Xi et al. 2025 (SBRT vs RFA)

Clinical question: What are the efficacy and safety outcomes of single recurrent hcc ≤5 cm?

Registry: NCT04047173 · Randomized open-label controlled trial; n=166. Evidence cut-off: 13 November 2026.

Design, eligibility and treatment

Population

Single recurrent HCC lesion ≤5 cm.

Intervention / comparator

SBRT versus RFA.

Design

Randomized open-label controlled trial; n=166.

Primary endpoint

Local PFS primary; PFS, OS and safety secondary.

Key efficacy outcomes

2-y LPFS 92.7% vs 75.8%; HR 0.45 (95% CI 0.24–0.87), p=0.014. PFS HR 0.76, p=0.190; 2-y OS 97.6% vs 93.9%, HR 0.91, p=0.830.

Safety

Acute and late AEs comparable.

Interpretation and limitations

Local-control advantage without demonstrated PFS or OS benefit.

Median survival differences and hazard ratios must not be converted into NNT. A patient pictogram is omitted unless a defensible fixed-time absolute event difference is reported.

Primary and supporting sources

Primary publication

Registry / supporting source

Primary-source data reviewed; the page explicitly identifies unavailable full-text toxicity details rather than imputing them.

Current-practice context · 13 November 2026

Historical trial results are distinct from current treatment recommendations. Check current jurisdiction-specific guidance, liver function, biomarker requirements, local expertise and regulatory availability before applying these findings. Comprehensive guideline reconciliation and browser-rendered QA remain pending.