Abstract
AIMS: Carbon-ion radiation therapy (CIRT) is a promising technological innovation for treating hepatocellular carcinoma (HCC). This study aimed to evaluate the effectiveness and safety of CIRT for primary, solitary, potentially resectable HCC in comparison to liver resection (LR). METHODS AND RESULTS: We retrospectively compared treatment effectiveness and safety between patients treated with CIRT and those who underwent LR for potentially resectable HCC at our institution. The clinical data for the CIRT group were obtained from a prospective observational study carried out at our institution, and additional information was obtained from clinical records. Their data were compared with those of patients who underwent LR during the same period. Twenty-three patients were included in the CIRT group and 41 in the LR group. In the overall cohort, the respective 3-and 5-year overall survival (OS) rates were 86.5% and 65.9% for the CIRT group and 90.2% and 79.7% for the LR group. The OS rates did not significantly differ between the two groups in the propensity score-matched cohort. The 3- and 5-year local control rates after CIRT were 77.0% and 77.0%, respectively. CIRT was associated with elevated albumin-bilirubin (ALBI) scores 3 and 6 months after treatment. CONCLUSION: CIRT for primary, solitary, potentially resectable HCC was associated with favorable clinical outcomes and satisfactory safety, with an acceptable elevation of the ALBI score. CIRT might achieve a favorable OS comparable to LR for potentially resectable HCC; however, further large-scale, prospective studies are needed for confirmation.