Evidence map›Paper›PMID 41642535›Full record

ArticleJapanese journal of radiology2026

Intensity-modulated proton therapy for patients with unresectable giant (≥ 10 cm) hepatocellular carcinoma: a retrospective analysis from two high-volume centers.

Jen-Yu Cheng, Yu-Ming Wang, Yen-Hao Chen, Chieh-Min Liu, Eng-Yen Huang, Hsin-You Ou, Tsung-Hui Hu, Sheng-Nan Lu, Chih-Chi Wang, Jeng-Hwei Tseng and 5 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Japanese journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Jen-Yu ChengDepartment of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan, ROC.
Yu-Ming WangDepartment of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan, ROC.
Yen-Hao ChenDivision of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Chieh-Min LiuDepartment of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan, ROC.
Eng-Yen HuangDepartment of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan, ROC.
Hsin-You OuDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Tsung-Hui HuDivision of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Sheng-Nan LuDivision of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Chih-Chi WangDivision of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Jeng-Hwei TsengDepartment of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital and University, Taoyuan City, Taiwan, ROC.
Shi-Ming LinDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and University, Taoyuan City, Taiwan, ROC.
Chen-Chun LinSchool of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
Kun-Ming ChanDepartment of General Surgery, Linkou Chang Gung Memorial Hospital and University, Taoyuan City, Taiwan, ROC.
Wan-Yu ChenDepartment of Radiation Oncology, National Taiwan University Cancer Center, Taipei, Taiwan, ROC.
Bing-Shen HuangDepartment of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan, ROC. beanson@cgmh.org.tw.ORCID http://orcid.org/0000-0002-0477-448X

Funding

Chang Gung Medical Foundation CMRPG3M1501Chang Gung Medical Foundation CMRPG8N0661
6 · The paper itself

Abstract

backgroundUnresectable giant hepatocellular carcinoma (HCC) has a poor prognosis, and few effective treatment methods are available. In this study, the clinical efficacy of intensity-modulated proton therapy (IMPT) was assessed.

methodsA retrospective review was conducted on 71 consecutive patients with giant HCC treated with IMPT at two medical centers from September 2019 to December 2022. The outcomes analyzed included liver and gastrointestinal toxicity, objective response rate (ORR), local control (LC), overall survival (OS), intrahepatic recurrence-free survival (IHRFS), and distant metastasis-free survival (DMFS).

resultsThe ORR was 90.2%. The one-year and two-year LC rates were 95.0% and 86.5%, respectively. The one-year and two-year OS rates were 80.0% and 53.8%, respectively, with a median OS of 26.7 months (95% CI 20.8-32.7). At one and two years, the IHRFS rates were 47.4% and 26.0%, and the DMFS rates were 57.7% and 36.8%, respectively. Multivariate analysis indicated that ECOG performance status (p = 0.008) and complete response (CR) after IMPT were independently associated with OS (p = 0.039). Two cases (2.8%) of Grade 3 gastrointestinal toxicity were observed. The incidence of liver failure after IMPT was 12.7%, of which 6.1% were considered radiation related.

conclusionsIMPT has potential for treating giant HCC. Despite the excellent LC and ORR, intrahepatic recurrence and distant metastasis remain significant factors affecting survival. More aggressive follow-up and additional therapeutic strategies are necessary, particularly for patients who do not achieve CR after treatment.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsProton TherapyRadiotherapy, Intensity-ModulatedAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesSurvival RateTreatment OutcomeHCCIMPTPencil beam scanningProton therapyRadiotherapy

Identifiers

PMID41642535

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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.