Ninety-five patients treated with PBT were analyzed compared to 836 patients treated by RFA as controls. The 1-year, 3-year, and 5-year recurrence-free survival (RFS) rates were 86.6%, 49.5%, and 35.5% in the PBT group and 59.5%, 34.0%, and 20.9% in the RFA group (p = 0.058); the respective OS rates were 97.6%, 77.8%, and 57.1% in the PBT group and 95.1%, 81.7%, and 67.7% in the RFA group (p = 0.16). No grade 3 or higher adverse events in the PBT, but two grade 3 adverse events occurred within 30 days of RFA in the RFA group. The authors concluded that no significant difference between the two treatment options, and PBT can be an alternative for patients with solitary treatment-naïve HCC.