The research sought to assess the efficiency and safety of proton beam therapy in the treatment of hepatocellular carcinoma with bile duct invasion, a disease with a poor prognosis and a lack of therapeutic consensus. Between 2009 and 2018, fifteen individuals with this ailment underwent proton beam treatment. The majority of patients had solitary tumors with central bile duct invasion. The 1-, 2-, and 3-year overall survival rates after therapy were 80%, 58.7%, and 40.2%, respectively. Local tumor control rates were equally high at these time periods, at 93.3%. However, progression-free survival rates fell to 72.7% after one year and 0% after two and three years. Proton beam treatment was generally well tolerated, with approximately half of patients experiencing acute grade 1-2 skin toxicity.

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