{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:35:56Z","timestamp":1776695756724,"version":"3.51.2"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP16lm0103004"],"award-info":[{"award-number":["JP16lm0103004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background\/Purpose<\/jats:title><jats:p>The study was designed to examine the role of particle beam therapy (PT) in the treatment of extrahepatic biliary cancer (EHC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review and meta\u2010analysis to compare the outcomes of PT and photon radiotherapy in treating EHC. Medline\/PubMed and Japan Medical Abstracts databases were screened using a systematic search strategy. The primary endpoint was overall survival (OS), pooled using a random effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 236 articles were retrieved. After screening, 11 articles were retained, comprising 2108 patients (nine photon articles, <jats:italic>n<\/jats:italic>\u2009=\u20092038 patients; two PT articles, <jats:italic>n<\/jats:italic>\u2009=\u200970 patients). We have updated and incorporated the outcomes of the prospective data registry (Proton\u2010net, <jats:italic>n<\/jats:italic>\u2009=\u2009137 patients) for PT. The 1\u2010year OS probability rates were 56% (95% confidence interval\u2009=\u200949%\u201362%) for the photon and 72% (65%\u201378%) for the PT groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The median survival time was 13.1\u2009months (11.0\u201315.1\u2009months) for the photon group and 18.8\u2009months (14.1\u201323.4\u2009months) for the PT group (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). The PT group demonstrated a superior OS rate compared to that observed in the photon group. The incidence rates of grade 3\u2009\u2264 toxicity was 18.5%\u201333% in the photon radiotherapy group and 2.9%\u201315% in the PT group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PT demonstrated superior outcomes with acceptable toxicity compared to those noted with photon radiotherapy for EHC in this meta\u2010analysis. In the absence of randomized trials, this meta\u2010analysis provides useful evidence that PT can be considered an effective therapeutic modality for EHC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.12156","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:14:29Z","timestamp":1747181669000},"page":"506-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Role of Particle Beam Therapy for Extrahepatic Biliary Cancer\u2014Updated Systematic Review and Meta\u2010Analysis for Comparison Between Photon and Particle Radiotherapy"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7508-7217","authenticated-orcid":false,"given":"Hideya","family":"Yamazaki","sequence":"first","affiliation":[{"name":"Department of Radiology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Kimoto","sequence":"additional","affiliation":[{"name":"Department of Radiology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Teramukai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuko","family":"Nakata","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Shibuya","sequence":"additional","affiliation":[{"name":"Gunma University Heavy Ion Medical Center  Maebashi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motohisa","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Southern TOHOKU Proton Therapy Center  Koriyama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Terashima","sequence":"additional","affiliation":[{"name":"Department of Radiology Hyogo Ion Beam Medical Center  Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Iizumi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton Medical Research Center University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Wakatsuki","sequence":"additional","affiliation":[{"name":"QST Hospital National Institutes for Quantum and Radiological Science and Technology  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Global Center for Biomedical Science and Engineering, Faculty of Medicine Hokkaido University  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takumi","family":"Fukumoto","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Ohtsuka","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_160831"},{"key":"e_1_2_8_3_1","unstructured":"National Cancer Center Cancer Information Service \u201cStatistics by Cancer Type: Gallbladder and Bile Duct \u201dhttps:\/\/ganjoho.jp\/reg_stat\/statistics\/stat\/cancer\/9_gallbladder.html."},{"key":"e_1_2_8_4_1","unstructured":"The National Comprehensive Cancer Network (NCCN) \u201cNCCN Clinical Practice Guidelines in Oncology. 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