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Non-classic radiation-induced liver disease after intensity-modulated radiotherapy for Child-Pugh grade B patients with locally advanced hepatocellular carcinoma.
Li, Jian-Xu; Zhang, Rui-Jun; Qiu, Mo-Qin; Yan, Liu-Ying; He, Mei-Ling; Long, Mei-Ying; Zhong, Jian-Hong; Lu, Hai-Yan; Zhou, Hong-Mei; Xiang, Bang-De; Liang, Shi-Xiong.
Afiliação
  • Li JX; Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021, China.
  • Zhang RJ; Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021, China.
  • Qiu MQ; Department of Respiratory Oncology, Guangxi Medical University Cancer Hospital, Nanning, China.
  • Yan LY; Department of General Affairs, Guangxi Medical University Cancer Hospital, Nanning, China.
  • He ML; Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021, China.
  • Long MY; School of Public Health, Guangxi Medical University, Nanning, 530021, China.
  • Zhong JH; Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021, China.
  • Lu HY; Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021, China.
  • Zhou HM; Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021, China.
  • Xiang BD; Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021, China. xiangbangde@gxmu.edu.cn.
  • Liang SX; Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021, China. shixliang@vip.sina.com.
Radiat Oncol ; 18(1): 48, 2023 Mar 08.
Article em En | MEDLINE | ID: mdl-36890592
ABSTRACT

BACKGROUND:

The incidence of classic radiation-induced liver disease (cRILD) has been significantly reduced. However, non-classic radiation-induced liver disease (ncRILD) remains a major concern following radiotherapy in patients with hepatocellular carcinoma (HCC). This study evaluated the incidence of ncRILD following intensity-modulated radiotherapy (IMRT) for Child-Pugh grade B (CP-B) patients with locally advanced HCC and established a nomogram for predicting ncRILD probability.

METHODS:

Seventy-five CP-B patients with locally advanced HCC treated with IMRT between September 2014 and July 2021 were included. The max tumor size was 8.39 cm ± 5.06, and the median prescribed dose was 53.24 Gy ± 7.26. Treatment-related hepatotoxicity was evaluated within three months of completing IMRT. A nomogram model was formulated to predict the probability of ncRILD, using univariate and multivariate analysis.

RESULTS:

Among CP-B patients with locally advanced HCC, ncRILD occurred in 17 (22.7%) patients. Two patients (2.7%) exhibited a transaminase elevation of ≥ G3, fourteen (18.7%) exhibited a Child-Pugh score increase of ≥ 2, and one (1.3%) demonstrated both a transaminase elevation of ≥ G3 and a Child-Pugh score increase of ≥ 2. No cRILD cases were observed. A mean dose to the normal liver of ≥ 15.1 Gy was used as the cutoff for ncRILD. Multivariate analysis revealed that the prothrombin time before IMRT, tumour number, and mean dose to the normal liver were independent risk factors for ncRILD. The nomogram established on the basis of these risk factors displayed exceptional predictive performance (AUC = 0.800, 95% CI 0.674-0.926).

CONCLUSIONS:

The incidence of ncRILD following IMRT for CP-B patients with locally advanced HCC was acceptable. A nomogram based on prothrombin time before IMRT, tumour number, and mean dose to the normal liver accurately predicted the probability of ncRILD in these patients.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Lesões por Radiação / Carcinoma Hepatocelular / Radioterapia de Intensidade Modulada / Neoplasias Hepáticas Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Lesões por Radiação / Carcinoma Hepatocelular / Radioterapia de Intensidade Modulada / Neoplasias Hepáticas Idioma: En Ano de publicação: 2023 Tipo de documento: Article