ArticleJournal of gastrointestinal oncology2019
Proton beam therapy versus stereotactic body radiotherapy for hepatocellular carcinoma: practice patterns, outcomes, and the effect of biologically effective dose escalation.
Article in Journal of gastrointestinal oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Evidence-based indications for proton therapy in adults determined using the GRADE approach.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Pooled it
- Comparison of proton vs. photon radiotherapy for liver cancer: a meta-analysis.BMC gastroenterology · 2026Pooled it
- Prospective Registry and Meta-Analysis of Particle Therapy for Hepatocellular Carcinoma: Clinical Outcomes and Real-World Impact.Cancer medicine · 2026Pooled it
- Unexpected Therapeutic Implications: The Abscopal Effect in the Management of Hepatocellular Carcinoma.Cancers · 2026Review
- Dose comparison of proton beam therapy with and without a multileaf collimator in the treatment of multiple hepatocellular carcinoma.Physics and imaging in radiation oncology · 2026Article
- The changes in imaging following proton beam therapy for pediatric hepatoblastoma.European journal of pediatrics · 2025Article
- Proton beam radiation therapy and the overall survival of adult and pediatric patients diagnosed with central nervous system tumors.BMC cancer · 2025Article
- Article
- Comparison of Proton Versus Photon SBRT for Treatment of Spinal Metastases Using Variable RBE Models.International journal of particle therapy · 2025Article
- Recent update of proton beam therapy for hepatocellular carcinoma: a systematic review and meta-analysis.Journal of liver cancer · 2024Article
- Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma.The oncologist · 2024Article
- Proton Beam Therapy for Intrahepatic Cholangiocarcinoma: A Multicenter Prospective Registry Study in Japan.Liver cancer · 2024Article
- Factors Associated With and Characteristics of Patients Receiving Proton Therapy at the End of Life.International journal of particle therapy · 2024Article
- High dose proton and photon-based radiation therapy for 213 liver lesions: a multi-institutional dosimetric comparison with a clinical perspective.La Radiologia medica · 2024Article
- Proton beam therapy for downstaging hepatocellular carcinoma with lobar portal vein tumor thrombosis to living donor liver transplantation.Hepatobiliary surgery and nutrition · 2023Article
- Advances and Challenges in Conducting Clinical Trials With Proton Beam Therapy.Seminars in radiation oncology · 2023Review
- Loco-regional therapies competing with radiofrequency ablation in potential indications for hepatocellular carcinoma: a network meta-analysis.Clinical and molecular hepatology · 2023Article
- Current evidence and the potential role of proton beam therapy for hepatocellular carcinoma.Clinical and molecular hepatology · 2023Review
- Article
- Study of hepatic toxicity in small liver tumors after photon or proton therapy based on factors predicting the benefits of proton.The British journal of radiology · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStereotactic body radiation therapy (SBRT) and proton beam therapy (PBT) generally are safe and effective for non-operative hepatocellular carcinoma (HCC). To date, data comparing the two modalities are limited. We aimed to identify the practice patterns and outcomes of nonsurgical HCC cases treated definitively with either SBRT or PBT.
methodsWe queried the National Cancer Database for T1-2N0 HCC patients receiving PBT or SBRT from 2004 to 2015. Patients were excluded for any treatment other than non-palliative external beam radiotherapy. A multivariable binomial regression model identified patterns of SBRT/PBT use, and propensity-matched multivariable Cox regression assessed correlates of survival.
resultsA total of 71 patients received PBT and 918 patients received SBRT (median follow-up 45 months). SBRT was used in 1.8% of nonoperative early stage HCC cases in 2004 and 4.2% of cases in 2015, whereas PBT was used in 0.1-0.2% of cases every year. The median biologically effective dose (BED) for SBRT and PBT was 100 Gy10 and 98 Gy10, respectively (OR =0.70, P=0.17). Factors predictive of receiving PBT included: white race, higher comorbidity score, higher education, metropolitan residence, tumors >5 cm and recent treatment (all P<0.05). Both PBT (HR =0.48, 95% CI: 0.29-0.78) and BED ≥100 Gy10 (HR =0.61, 95% CI: 0.38-0.98) were independent predictors for longer survival.
conclusionsAlthough not implying causation and requiring prospective corroboration, PBT was independently associated with longer survival than SBRT, despite being delivered to HCC patients with multiple poor prognostic factors. PBT may also allow for safer BED escalation, which also independently associated with outcomes.
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