This systematic review and meta-analysis conducted by the Tsukuba group, Japan, included 37 studies (photon 23, proton 14) and reported no significant differences between treatment modalities for pediatric non-parameningial rhabdomyosarcoma (RMS) in OS from 1 to 5 years. However, inferior LC rates at 1- and 3-year with PBT were reported in parameningial RMS. The authors remarked that the inferior LC rates with proton may be attributed to the limited number of proton studies.