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- Title
Radiation-induced liver disease after stereotactic body radiotherapy for small hepatocellular carcinoma: clinical and dose-volumetric parameters.
- Authors
Jung, Jinhong; Yoon, Sang Min; Kim, So Yeon; Cho, Byungchul; Park, Jin-Hong; Kim, Su Ssan; Song, Si Yeol; Lee, Sang-Wook; Ahn, Seung Do; Choi, Eun Kyung; Kim, Jong Hoon
- Abstract
<bold>Background: </bold>To investigate the clinical and dose-volumetric parameters that predict the risk of radiation-induced liver disease (RILD) for patients with small, unresectable hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).<bold>Methods: </bold>Between March 2007 and December 2009, 92 patients with HCC treated with SBRT were reviewed for RILD within 3 months of completing treatment. RILD was evaluated according to the Common Terminology Criteria for Adverse Events, version 3.0. A dose of 10-20 Gy (median, 15 Gy) per fraction was given over 3-4 consecutive days for a total dose of 30-60 Gy (median, 45 Gy). The following clinical and dose-volumetric parameters were examined: age, gender, Child-Pugh class, presence of hepatitis B virus, gross tumor volume, normal liver volume, radiation dose, fraction size, mean dose to the normal liver, and normal liver volumes receiving from < 5 Gy to < 60 Gy (in increments of 5 Gy).<bold>Results: </bold>Seventeen (18.5%) of the 92 patients developed grade 2 or worse RILD after SBRT (49 patients in grade 1, 11 in grade 2, and 6 in ≥ grade 3). On univariate analysis, Child-Pugh class was identified as a significant clinical parameter, while normal liver volume and normal liver volumes receiving from < 15 Gy to < 60 Gy were the significant dose-volumetric parameters. Upon multivariate analysis, only Child-Pugh class was a significant parameter for predicting grade 2 or worse RILD.<bold>Conclusions: </bold>The Child-Pugh B cirrhosis was found to have a significantly greater susceptibility to the development of grade 2 or worse RILD after SBRT in patients with small, unresectable HCC. Additional efforts aimed at testing other models to predict the risk of RILD in a large series of HCC patients treated with SBRT are needed.
- Publication
Radiation Oncology, 2013, Vol 8, Issue 1, p249
- ISSN
1748-717X
- Publication type
journal article
- DOI
10.1186/1748-717X-8-249