Adverse hepatic events caused by radiotherapy for advanced hepatocellular carcinoma.
BACKGROUND: Radiotherapy is often used to treat patients with unresectable advanced hepatocellular carcinoma ( HCC). The present study examines the nature and frequency of adverse events with respect to liver function in such patients after radiotherapy. METHODS: Forty-six patients with HCC who underwent radiotherapy were retrospectively examined. Radiotherapy was applied using coplanar 2-3-beam arrangements to a target dose of 50 Gy/5 weeks. The adverse hepatic events were evaluated according to the National Cancer Institute Common Toxicity Criteria and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme during the acute phase and the late phase by following the patients for up to 1 year. The influence on survival by adverse hepatic events and other factors was analyzed. RESULTS: The full irradiation dose of 50 Gy was given to 40 patients (87.0%). Grade 3 or 4 toxicity was observed in 18 (39.1%) within 3 months after radiotherapy and in 11 (33.3%) of 33 thereafter, respectively. The most frequent and serious adverse events were hyperbilirubinemia, hypoalbuminemia, and ascites. The independent adverse prognostic factors for survival were portal vein tumor thrombus (P = 0.0012), tumor response (P = 0.011), acute adverse hepatic event (P = 0.012), and late adverse hepatic event (P = 0.015). CONCLUSIONS: Hypoalbuminemia, hyperbilirubinemia, and ascites were important hepatic adverse events that developed after applying radiotherapy to treat advanced HCC. These adverse events seriously affected survival.[1]References
- Adverse hepatic events caused by radiotherapy for advanced hepatocellular carcinoma. Furuse, J., Ishii, H., Nagase, M., Kawashima, M., Ogino, T., Yoshino, M. J. Gastroenterol. Hepatol. (2005) [Pubmed]
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