SynthesisBMC gastroenterology2026
Comparison of proton vs. photon radiotherapy for liver cancer: a meta-analysis.
Synthesis in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo systematically evaluate the efficacy and safety of proton beam radiotherapy (PBT) compared with photon radiotherapy in the treatment of hepatocellular carcinoma (HCC), thereby providing evidence-based guidance for clinical decision-making in radiotherapy modality selection.
methodsA systematic search of PubMed, Web of Science, Cochrane Library, and EMBASE databases was conducted to identify clinical studies comparing PBT with photon radiotherapy for HCC. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and the certainty of evidence was evaluated using the GRADE system. Meta-analysis was performed using Review Manager 5.4. The primary outcomes assessed were overall survival (OS), radiation-induced liver injury (RILD), and non-classical RILD.
resultsFour retrospective cohort studies were included. Meta-analysis results indicated that the PBT group had a hazard ratio for OS of 0.45 (95% CI: 0.34-0.60, P < 0.00001). However, moderate heterogeneity was observed for this outcome (I² = 48%), accompanied by significant publication bias, resulting in a low certainty of evidence. Conversely, PBT significantly reduced the risk of RILD (OR = 0.26, 95% CI: 0.15-0.46, P < 0.00001) and non-classical RILD (OR = 0.27, 95% CI: 0.15-0.47, P < 0.00001). Both outcomes demonstrated no heterogeneity (I² = 0%) and no significant publication bias, yielding a moderate certainty of evidence. The number needed to treat to prevent one case of liver injury was approximately five.
conclusionCompared with photon radiotherapy, PBT offers a clear advantage in reducing the risk of RILD and non-classical RILD in patients with HCC. However, the potential benefit of PBT in improving OS remains inconclusive due to limitations related to study design and publication bias, resulting in a low level of evidence. Clinical selection of radiotherapy modalities should be individualized based on patients' liver function reserve, tumor characteristics, and medical conditions. Large-scale, multicenter prospective studies are warranted to further validate the long-term survival benefits of PBT.
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.