Radiation-induced liver disease in three-dimensional conformal radiation therapy for primary liver carcinoma: The risk factors and hepatic radiation tolerance
- Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China)
- Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning (China)
Purpose: To identify risk factors relevant to radiation-induced liver disease (RILD) and to determine the hepatic tolerance to radiation. Methods and Materials: The data of 109 primary liver carcinomas (PLC) treated with hypofractionated three-dimensional conformal radiation therapy (3D-CRT) were analyzed. Seventeen patients were diagnosed with RILD and 13 of 17 died of it. Results: The risk factors for RILD were late T stage, large gross tumor volume, presence of portal vein thrombosis, association with Child-Pugh Grade B cirrhosis, and acute hepatic toxicity. Multivariate analyses demonstrated that the severity of hepatic cirrhosis was a unique independent predictor. For Child-Pugh Grade A patients, the hepatic radiation tolerance was as follows: (1) Mean dose to normal liver (MDTNL) of 23 Gy was tolerable. (2) For cumulative dose-volume histogram, the tolerable volume percentages would be less than: V{sub 5} of 86%, V{sub 1} of 68%, V{sub 15} of 59%, V{sub 2} of 49%, V{sub 25} of 35%, V{sub 3} of 28%, V{sub 35} of 25%, and V{sub 4} of 20%. (3) Tolerable MDTNL could be estimated by MDTNL (Gy) = -1.686 + 0.023 * normal liver volume (cm{sup 3}). Conclusion: The predominant risk factor for RILD was the severity of hepatic cirrhosis. The hepatic tolerance to radiation could be estimated by dosimetric parameters.
- OSTI ID:
- 20793501
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 65, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2005.12.031; PII: S0360-3016(06)00089-7; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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