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@ARTICLE{HoffmeisterWittmann:298967,
      author       = {P. Hoffmeister-Wittmann and P. Hoegen-Saßmannshausen$^*$
                      and L. Wicklein and F. Weykamp$^*$ and K. Seidensaal and C.
                      Springfeld and M. Dill$^*$ and T. Longerich and P.
                      Schirmacher and A. Mehrabi and R. M. Mathy and B. C. Köhler
                      and J. Debus$^*$ and K. Herfarth and J. Liermann},
      title        = {{S}tereotactic body radiotherapy with carbon ions as local
                      ablative treatment in patients with primary liver cancer.},
      journal      = {Radiation oncology},
      volume       = {20},
      number       = {1},
      issn         = {1748-717X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2025-00396},
      pages        = {23},
      year         = {2025},
      abstract     = {Liver cancer is the third leading cause of cancer related
                      death due to treatment resistance and late onset of symptoms
                      (Rumgay in J Hepatol 77: 1598-1606, 2022). The role of
                      external beam radiotherapy (EBRT) in treatment of
                      unresectable liver cancer needs to be defined. The use of
                      particle therapy such as carbon ion radiation therapy (CIRT)
                      with high linear energy transfer (LET) could increase
                      efficacy of EBRT while limiting the toxic effects of
                      radiation on non-cancerous liver tissue. Promising effects
                      of CIRT have been described in several studies during the
                      past decades, mostly in Japan. To date, no standardized
                      treatment protocol has been established and European data on
                      CIRT for liver cancer is lacking. This retrospective
                      analysis aims to investigate efficacy and safety of
                      hypofractionated CIRT compared to photon-based stereotactic
                      body radiation (SBRT) in primary liver cancer.Thirty-six (n
                      = 36) and twenty (n = 20) patients with primary malignant
                      liver tumors were treated with hypofractionated CIRT (4
                      fractions) and photon-based SBRT, respectively, between 2011
                      and 2022 and were retrospectively evaluated for survival,
                      local control, and toxicity.Two-year local control rate
                      after CIRT was $92.3\%.$ Compared to photon- based SBRT,
                      CIRT scores with a significantly longer median distant
                      progression free survival (3.1 versus 0.9 years). In a
                      matched pair comparison of the two treatment regimens, the
                      CIRT cohort demonstrated both longer 2-year overall survival
                      $(100\%$ versus $59.6\%)$ and longer 2-year distant PFS
                      $(75.7\%$ versus $22.9\%).$ No significant impairment of
                      liver function was observed in either cohort.In this
                      retrospective analysis, patients who received CIRT presented
                      excellent local tumor control and had better oncologic
                      outcomes than patients who received photon-based SBRT. SBRT
                      with carbon ions is a promising local ablative treatment
                      option that needs further investigation in large prospective
                      trials.},
      keywords     = {Humans / Liver Neoplasms: radiotherapy / Radiosurgery:
                      adverse effects / Radiosurgery: methods / Retrospective
                      Studies / Heavy Ion Radiotherapy: adverse effects / Aged /
                      Male / Female / Middle Aged / Aged, 80 and over / Survival
                      Rate / Adult / Carcinoma, Hepatocellular: radiotherapy /
                      Carcinoma, Hepatocellular: mortality / Carcinoma,
                      Hepatocellular: pathology / Carbon ion radiotherapy (Other)
                      / Cholangiocarcinoma (Other) / Hepatocellular carcinoma
                      (Other) / Hypofractionation (Other) / Local control (Other)
                      / SBRT (Other)},
      cin          = {E050 / D500 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)D500-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39966902},
      doi          = {10.1186/s13014-025-02594-y},
      url          = {https://inrepo02.dkfz.de/record/298967},
}