DOI: 10.1097/mph.0000000000003291 ISSN: 1077-4114

Hypofractionated Proton Beam Therapy for Localized Residual or Recurrent Unresectable Hepatoblastoma

Yu-Chen Chang, Tang-Her Jaing, Ting-Chi Yeh, Yao-Yu Wu, Wei-Heng Kao, Chen-Kan Tseng

Background:

We evaluated hypofractionated proton beam therapy (PBT) feasibility for unresectable hepatoblastoma (HBL).

Observations:

Six patients with residual/relapsed localized HBL received PBT (50 to 60 Gy (RBE) in 10 fractions) between April 2019 and September 2024, with follow-up through September 2025. After 55-month follow-up, 5 patients remained alive without disease. One marginal recurrence was successfully salvaged by re-irradiation, and another bridged to hepatectomy (10% viable tumor). Toxicities were minimal, with one grade 2 duodenitis. One patient died of treatment-unrelated myelodysplastic syndrome while remaining HBL-free.

Conclusions:

Hypofractionated PBT is a feasible, well-tolerated salvage option for refractory HBL, providing encouraging local control.