Proton Beam Therapy versus Radiofrequency Ablation for Patients with Treatment-Naïve Single Hepatocellular Carcinoma: A Propensity Score Analysis.

Introduction: Proton beam therapy (PBT) is known to be an effective locoregional treatment for hepatocellular carcinoma (HCC). However, few comparative studies in treatment-naïve cases have been reported. The aim of this study was to compare the survival outcomes of PBT with those of radiofrequency ablation (RFA) in patients with treatment-naïve solitary HCC.
Methods: Ninety-five consecutive patients with treatment-naïve HCC, a single nodule measuring ≤5 cm in diameter, and a Child-Pugh score of ≤8 who were treated with PBT at the University of Tsukuba Hospital between 2001 and 2013 were enrolled in the study. In addition, 836 patients with treatment-naïve HCC treated by RFA at the University of Tokyo Hospital during the same period were analyzed as controls. Recurrence-free survival (RFS) and overall survival (OS) were compared in 83 patient pairs after propensity score matching.
Results: The 1-year, 3-year, and 5-year RFS rates were 86.6%, 49.5%, and 35.5%, respectively, in the PBT group and 59.5%, 34.0%, and 20.9% in the RFA group ( p = 0.058); the respective OS rates were 97.6%, 77.8%, and 57.1% in the PBT group and 95.1%, 81.7%, and 67.7% in the RFA group ( p = 0.16). Regarding adverse effects, no grade 3 or higher adverse events were noted in the PBT; however, two grade 3 adverse events occurred within 30 days of RFA in the RFA group: one hemoperitoneum and one hemothorax.
Discussion: After propensity score matching, PBT showed no significant difference in RFS and OS compared to RFA. PBT can be an alternative for patients with solitary treatment-naïve HCC.
Competing Interests: Ryosuke Tateishi has received lecture fees from STARmed Co., Ltd., Medtronic plc, Merk Sharp & Dohme, Chugai Pharmaceutical Co., Ltd., Bristol-Meyers Squibb, Giliad Sciences, AbbVie GK, Mitsubishi Tanabe Pharma Corporation, Otsuka Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Eisai Co., Ltd., and Bayer Co., Ltd. Hayato Nakagawa has received lecture fees from Bristol-Meyers Squibb, Giliad Sciences, AbbVie GK, Mitsubishi Tanabe Pharma Corporation, Otsuka Pharmaceutical Co., Ltd., and Sumitomo Dainippon Pharma Co., Ltd. Yoshinari Asaoka has received consultation fees from Eisai Co., Ltd. Shuichiro Shiina has received lecture fees from Starmed Co., Ltd., Medtronic plc, Japan Lifeline Co., Ltd., Canon Medical Co., Ltd., Shionogi Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Giliad Sciences, AbbVie GK, Eisai Co., Ltd., and Bayer Co., Ltd. Kazuhiko Koike has received lecture fees from Eisai, Bayer, MSD, Abbvie, Gilead, and Otsuka Pharmaceutical Co., Ltd.
(Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel.)