ArticleRadiation oncology (London, England)2020
Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis.
Article in Radiation oncology (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 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
- Proton beam therapy indications in the Kingdom of Saudi Arabia: A SARO clinical practice guideline.Saudi medical journal · 2025Guideline
- Proton Radiation Therapy: A Systematic Review of Treatment-Related Side Effects and Toxicities.International journal of molecular sciences · 2024Pooled it
- Multi-Institutional Proton Beam Therapy Outcomes for Hepatocellular Carcinoma From the Proton Collaborative Group REG001-09 Registry Study.Advances in radiation oncology · 2026Article
- Proton beam therapy versus trans-arterial chemoembolization for BCLC stage B hepatocellular carcinoma-a propensity-matched analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Intensity-modulated proton therapy for patients with unresectable giant (≥ 10 cm) hepatocellular carcinoma: a retrospective analysis from two high-volume centers.Japanese journal of radiology · 2026Article
- Recent advancements in radiotherapy for hepatocellular carcinoma.ESMO gastrointestinal oncology · 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
- Cold-spot driven local failure after stereotactic body radiation therapy for colorectal liver metastases.Frontiers in oncology · 2026Article
- Simultaneous integrated boost and protection proton beam therapy approach for hepatocellular carcinoma.Clinical and translational radiation oncology · 2025Article
- Dynamic profiles of early biological responses to predict the treatment efficacy of proton therapy in liver cancer assessed with in vivo kinetic [18F]-FDG PET/MRI.Radiation oncology (London, England) · 2025Article
- Intensity-Modulated Proton Therapy for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis.Journal of hepatocellular carcinoma · 2025Article
- 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
- Review
- Tumor Response on Diagnostic Imaging after Proton Beam Therapy for Hepatocellular Carcinoma.Cancers · 2024Article
- Current evidence and the potential role of proton beam therapy for hepatocellular carcinoma.Clinical and molecular hepatology · 2023Review
- Metastasis-Directed Local Therapy of Hepatic Oligometastasis from Colorectal Cancer and Future Perspective in Radiation Therapy.Cancer research and treatment · 2023Article
- Recent Advances in Metal-Based NanoEnhancers for Particle Therapy.Nanomaterials (Basel, Switzerland) · 2023Review
- 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
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProton radiotherapy has a dosimetric advantage over photon radiotherapy. Many retrospective studies have shown promising results with proton radiotherapy in treating hepatocellular carcinoma (HCC). However, clinical evidence demonstrating the benefit of protons over photons is still limited. We therefore compared the clinical outcomes of the two modalities using medical research databases from our medical foundation.
methodsWe conducted a propensity score-matched cohort study based on our multi-institution medical organization research database. From January 2007 to January 2018, a total of 413 patients (photon: 349; proton: 64) who were diagnosed with HCC and primarily treated with radiotherapy with curative intent were enrolled. Overall survival (OS) and radiation-induced liver disease (RILD) were assessed. Stratified analysis was also performed to evaluate the heterogeneous effects of the two arms.
resultsA total of 110 patients (photon: 55; proton: 55) were analyzed in the propensity-matched series. The matched groups were balanced for baseline tumor risk factors. Cox regression analysis revealed a significant survival benefit in the proton group (p = 0.032, HR 0.56, 95% CI 0.33-0.96). The median overall survival in the proton group was not reached and that in the photon group was 17.4 months. The biological equivalent dose of radiotherapy was significantly higher in the proton group than in the photon group (median, 96.56 Gray [relative biological effectiveness] vs. 62.5 Gray, p < 0.001). The risk of RILD was significantly lower in the proton group (11.8% vs. 36%, p = 0.004).
conclusionsProton radiotherapy could deliver a higher radiation dose than photon radiotherapy without increasing the risk of RILD and result in a better overall survival rate for those diagnosed with HCC and treated with radiotherapy with curative intent.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.