NCCN guidelines lists radiation, ablation and transarterial chemoembolization (TACE) as comparable options for liver-confined inoperable hepatocellular carcinoma (HCC). But are their outcomes really comparable? A pooled analysis of three prospective randomized trials (n=142) comparing external beam radiation to TACE suggests: no, not at all. Both local control (HR 0.16) and even progression-free survival (HR 0.37) were many-fold times better with radiation than TACE. There was no significant difference in overall survival (RR 0.79) or grade 3+ toxicity (RR 0.86). | Kuehnle, Cancer 2025
