This study from Japan reported favorable results of PBT in treatment of 116 patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Sixty-three patients received PBT as definitive treatment and 53 as palliative treatment. The representative dose was 72.6 Gy (RBE) in 22 fractions. With a median follow-up period for survivors with definitive treatment of 33.5 months, this study reported a 5-year OS rate of 25.1%. The authors suggested PBT can be a useful option because of the favorable results compared with those of other therapies.