质子束治疗 (PBT) 被认为是治疗肝细胞癌 (HCC) 的有效局部治疗方法。然而，关于未接受治疗的病例的比较研究却很少报道。本研究的目的是比较 PBT 与射频消融 (RFA) 治疗初治孤立性 HCC 患者的生存结果。连续 95 名初治 HCC 患者，单个结节直径≤5 cm ，且Child-Pugh评分≤8的2001年至2013年间在筑波大学医院接受PBT治疗的患者被纳入该研究。此外，还分析了同期在东京大学医院接受 RFA 治疗的 836 例初治 HCC 患者作为对照。倾向评分匹配后比较83对患者的无复发生存率（RFS）和总生存率（OS）。1年、3年和5年RFS率分别为86.6%、49.5%和35.5%， PBT 组和 RFA 组分别为 59.5%、34.0% 和 20.9% (p = 0.058)； PBT 组的 OS 率分别为 97.6%、77.8% 和 57.1%，RFA 组的 OS 率分别为 95.1%、81.7% 和 67.7%（p = 0.16）。关于不良反应，PBT 中未发现 3 级或以上不良事件；然而，RFA 组在 RFA 30 天内发生了 2 例 3 级不良事件：1 例腹腔积血和 1 例血胸。倾向评分匹配后，PBT 与 RFA 相比，RFS 和 OS 没有显着差异。 PBT 可以成为未经单独治疗的 HCC 患者的替代方案。作者版权所有 © 2022。由巴塞尔 S. Karger AG 出版。

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.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.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.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.Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel.