Hung SP, Huang BS, Hsieh CE, et al. - Researchers examined 30 patients with unresectable cholangiocarcinoma (CC) who had undergone proton beam therapy (PBT) between November 2015 and December 2017 for their clinical outcomes and failure patterns. The median size of the tumor was 7 cm. Regional lymph node metastases were observed in 17 patients (56.7%). The median radiation dose was 72.6 cobalt gray equivalents, and concurrent chemotherapy was provided in 23 patients (76.7%). They observed a better median progression-free survival for patients who received concurrent chemotherapy (12.1 vs 4.7 mo). Acute skin reactions were the most common form of acute toxicity from PBT; these were rarely severe (grade III: 7% of patients). Outcomes support the clinical utility of PBT in patients with unresectable CC, even in the presence of large tumors or regional nodal metastases. Durable symptom relief was achieved with its use, without raising acute or late toxicity.