{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T11:40:20Z","timestamp":1776512420973,"version":"3.51.2"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1144","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives:<\/jats:title>\n                  <jats:p>In a previous study of hepatic toxicity, the following three factors were identified to predict the benefits of proton beam therapy (PBT) for hepatocellular carcinomas (HCCs) with a maximum diameter of \u22645\u2009cm and Child-pugh grade A (CP-A): number of tumors (1 vs \u22652), the location of tumors (hepatic hilum or others), and the sum of the diameters of lesions. The aim of this study is to analyze the association between these three factors and hepatic toxicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>We retrospectively reviewed patients of CP-A treated with PBT or photon stereotactic body radiotherapy (X-ray radiotherapy, XRT) for HCC \u22645\u2009cm. For normal liver dose, the V5, V10, V20 (volumes receiving 5, 10, and 20\u2009Gy at least), and the mean dose was evaluated. The albumin-bilirubin (ALBI) and CP score changes from the baseline were evaluated at 3 and 6 months after treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>In 89 patients (XRT: 48, PBT: 41), those with two or three (2\u20133) predictive factors were higher normal liver doses than with zero or one (0\u20131) factor. In the PBT group, the ALBI score worsened more in patients with 2\u20133 factors than those with 0\u20131 factor, at 3 months (median: 0.26 vs 0.02, p = 0.032) and at 6 months (median: 0.35 vs 0.10, p = 0.009). The ALBI score change in the XRT group and CP score change in either modality were not significantly different in the number of predictive factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>The predictive factor numbers predicted the ALBI score change in PBT but not in XRT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>This study suggest that the number of predictive factors previously identified (0\u20131 vs 2\u20133) were significantly associated with dosimetric parameters of the normal liver in both modalities. In the proton group, the number of predictive factors was associated with a worsening ALBI score at 3 and 6 months, but these associations were not found in the photon SBRT group.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20220720","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T13:17:22Z","timestamp":1673529442000},"source":"Crossref","is-referenced-by-count":3,"title":["Study of hepatic toxicity in small liver tumors after photon or proton therapy based on factors predicting the benefits of proton"],"prefix":"10.1093","volume":"96","author":[{"given":"Yusuke","family":"Uchinami","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Hokkaido University Faculty of Medicine , Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Katoh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hokkaido University Faculty of Medicine , 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