SynthesisCancer medicine2026
Prospective Registry and Meta-Analysis of Particle Therapy for Hepatocellular Carcinoma: Clinical Outcomes and Real-World Impact.
Synthesis in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed.
- Multi-Institutional Proton Beam Therapy Outcomes for Hepatocellular Carcinoma From the Proton Collaborative Group REG001-09 Registry Study.Advances in radiation oncology · 2026Article
- Association of Chronological Age and Comorbidity Burden with Outcomes After Proton Beam Therapy for Hepatocellular Carcinoma.Cancers · 2026Article
- Prognostic Impact of Arterial Phase Hyperenhancement After Proton Beam Therapy for Untreated Solitary Hepatocellular Carcinoma.Cancer medicine · 2026Article
- Stereotactic body radiation therapy for hepatocellular carcinoma larger than 5 cm: a systematic review and meta-analysis.Japanese journal of radiology · 2026Article
Corrections and comments
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Authors and funding
30 authors.
Funding
Abstract
BACKGROUND AND
aimsThis study aimed to evaluate the clinical efficacy of particle therapy for hepatocellular carcinoma (HCC) by integrating a prospective registry and a systematic meta-analysis. Our findings also reflect the real-world impact of this evidence, which contributed to the national health insurance approval of particle therapy for HCC tumors ≥ 4 cm in Japan.
methodsPatients who received particle therapy for HCC from May 2016 to June 2018 were registered. Ninety studies (25 particle therapy, 26 non-SBRT, 36 SBRT, 3 studies reporting multiple modalities) were selected.
resultsA total of 836 cases (proton beam therapy 576, carbon therapy 260) were examined. The median overall survival (OS) was 53.7 months (95% CI 47.4-NA). The 1-, 2-, 3- and 4-year OS rates were 85.2% (95% CI 82.6%-87.4%), 71.4% (68.1%-74.4%), 60.5% (56.9%-63.9%), and 53.5% (49.1%-57.7%), respectively; and the 1-, 2-, 3- and 4-year local recurrence rates were 3.5% (2.1%-4.9%), 8.8% (6.3%-10.8%), 12.0% (9.3%-14.8%), and 13.6% (10.5%-16.7%), respectively. In the meta-analysis and registry data, the 1-, 2-, and 3-year OS rates of particle therapy and SBRT for small HCC (< 4 cm) were 90.0%/87.7% (p = 0.4788), 75.3%/73.6% (p = 0.6724), and 62.8%/63.5% (p = 0.9771), respectively; and the 1-, 2-, and 3-year OS rates of particle therapy, SBRT and non-SBRT for large HCC (≥ 4 cm) were 81.1%/62.0% (p = 0.0032)/66.8% (p = 0.0021), 65.4%/38.1% (p = 0.0001)/38.4% (p = 0.0001), and 50.4%/31.8% (p = 0.0001)/25.9% (p = 0.0001), respectively.
conclusionsA prospective registry study and meta-analysis indicated that particle therapy is a better treatment modality than SBRT for large HCC. Particle therapy and SBRT gave similar outcomes for small HCC. These findings contributed to the adoption of particle therapy for tumors ≥ 4 cm under Japan's national health insurance, highlighting its real-world impact.
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