{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:34:19Z","timestamp":1789986859414,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T00:00:00Z","timestamp":1748131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>No classification methods to predict prognosis after carbon\u2010ion radiotherapy for hepatocellular carcinoma have yet been reported. This study aimed to develop risk classification for cancer\u2010specific survival (CSS) after carbon\u2010ion radiotherapy for hepatocellular carcinoma using decision tree analysis as a data\u2010mining method. In this single\u2010center, retrospective study, we analyzed 90 consecutive patients with hepatocellular carcinoma treated with carbon\u2010ion radiotherapy between 2018 and 2022. Liver tumors were irradiated at 60\u2009Gy (relative biological effectiveness [RBE]) in four fractions. If the tumor was close to the gastrointestinal tract, it was irradiated at 60\u2009Gy [RBE] in 12 fractions. Univariate and multivariate analyses of progression\u2010free survival (PFS) and CSS were performed to assess patients' background and treatment\u2010related factors. Decision tree analysis (DTA) was performed to assess prognostic factors for CSS that were significantly different in the multivariate analysis. The median follow\u2010up period was 32.8\u2009months for all patients and 35.6\u2009months for survivors. Multivariate analysis identified dose fractionation and pretreatment alpha\u2010fetoprotein values as significant prognostic factors for PFS and CSS. Moreover, clinical stage and pretreatment protein induced by vitamin K absence or antagonist \u0399\u0399 values were significant prognostic factors for CSS. DTA revealed that the patients could be divided into three groups according to prognosis: low\u2010risk, high\u2010risk, and intermediate\u2010risk. Consequently, the 3\u2010year CSS rates for the low\u2010, intermediate\u2010, and high\u2010risk groups were 100%, 73.3%, and 44.4%, respectively. DTA represents a new method for risk classification for CSS after carbon\u2010ion radiotherapy for hepatocellular carcinoma based on tumor markers and clinical stage.<\/jats:p>","DOI":"10.1111\/cas.70079","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:04:08Z","timestamp":1748203448000},"page":"2198-2207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Novel Method for Prognostic Risk Classification After Carbon\u2010Ion Radiotherapy for Hepatocellular Carcinoma Using Data\u2010Mining Methods"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5054-4629","authenticated-orcid":false,"given":"Kazuhiko","family":"Hayashi","sequence":"first","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"},{"name":"Department of Radiation Oncology Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Ichise","sequence":"additional","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Anzai","sequence":"additional","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azusa","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruki","family":"Teshima","sequence":"additional","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Radiology Osaka Heavy Ion Therapy Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.6004\/JNCCN.2021.0022"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/S13014\u2010021\u201001761\u20101"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.08.015"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0360\u20103016(98)00544\u20106"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010015\u20100491\u20108"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.11.033"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30816"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/CAS.15633"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010017\u20103724\u20104"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/LIV.13969"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.05.003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1023\/a:1016409317640"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010018\u201028650\u20100"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13348"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010022\u201012598\u20107"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010024\u201002444\u20103"},{"key":"e_1_2_11_18_1","volume-title":"International Union Against Cancer. TNM Classification of Malignant Tumours","author":"Sobin L. H.","year":"2009"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJROBP.2011.05.011"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13376"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0268087"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000520277"}],"container-title":["Cancer Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cas.70079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T08:34:11Z","timestamp":1754296451000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cas.70079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,25]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/cas.70079"],"URL":"https:\/\/doi.org\/10.1111\/cas.70079","archive":["Portico"],"relation":{},"ISSN":["1347-9032","1349-7006"],"issn-type":[{"value":"1347-9032","type":"print"},{"value":"1349-7006","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,25]]},"assertion":[{"value":"2025-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}