The cases showing objective tumor response after risk-adapted proton beam therapy (PBT) with three dose-fractionation regimens (regimen A, B, and C) according to the proximity of the gastrointestinal organs (<1 cm [A–C], 1–1.9 cm [D–F], and ≥2 cm [G–I], respectively). A, D, and G: Pre-treatment computed tomography (CT) scans showing the primary tumor and/or tumor vascular thrombosis (TVT) (arrow). B, E, and H: The patient received risk-adapted PBT (50 GyE, 60 GyE, and 66 GyE in 10 fractions to PTV1, respectively, and 30 GyE in 10 fractions to PTV2). C, F, and I: One-year follow-up CT scans after risk-adapted PBT showing notable reductions of the primary tumor and/or TVT (arrow). Abbreviations: PTV, planning target volume.