Analysis of radiation-induced liver disease using the Lyman NTCP model

Dawson, Laura A.; Normolle, Daniel P.; Balter, James M.; McGinn, Cornelius J.; Lawrence, Theodore S.; Haken, Randall K. Ten

doi:10.1016/s0360-3016(02)02846-8

Cited by 685 publications

(508 citation statements)

References 28 publications

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“…The curve represents the relation of volume irradiated and dose for a 5% risk of RILD. When the volume irradiated is Ͻ 20%, it is predicted that Ͼ 100 Gy (in 1.5 Gy per fraction) will be associated with a very low risk of toxicity (data from Dawson et al 84 ).…”

Section: Conformal Rtmentioning

confidence: 99%

Radiation therapy for hepatocellular carcinoma

Hawkins

Dawson

2006

Cancer

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221

171

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Technologic advances have provided the means to deliver tumoricidal doses of radiation therapy (RT) to patients with unresectable hepatocellular carcinoma (HCC) while avoiding critical normal tissues, providing the opportunity to use RT for curative intent treatment of HCC. For the current report, the expanded role of external beam RT in the setting of HCC from palliation to cure was reviewed. A systematic literature search was undertaken using the MEDLINE data base and secondary references to identify peer-reviewed, English-language articles that re- control response rates ranged from 40% to 90%, and the median survival ranges from 10 months to 25 months. For patients with HCC who had portal vein thrombus, the median survival after RT to treat the thrombus and/or the hepatic tumor with or without TACE ranged from 5.3 months to 9.7 months. Although outcomes after high-dose conformal RT for liver-confined HCC were excellent, the potential survival benefit of RT should be tested in randomized controlled trials that require international collaboration.

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Section: Conformal Rtmentioning

confidence: 99%

Radiation therapy for hepatocellular carcinoma

Hawkins

Dawson

2006

Cancer

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221

171

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“…With the advent of highly conformal radiation treatment planning and delivery technology, tumoricidal doses could be delivered safely provided that the mean dose to the normal liver was limited to below hepatic irradiation tolerance 26. In this study, that 7 of 23 (30.4%) patients had been diagnosis of RILD after RT does not represent the clinical incidence rate of RILD.…”

Section: Discussionmentioning

confidence: 85%

Investigation of dosimetric variations of liver radiotherapy using deformable registration of planning CT and cone‐beam CT

Huang

Chen

et al. 2016

J Applied Clin Med Phys

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Many patients with technically unresectable or medically inoperable hepatocellular carcinoma (HCC) had hepatic anatomy variations as a result of interfraction deformation during fractionated radiotherapy. We conducted this retrospective study to investigate interfractional normal liver dosimetric consequences via reconstructing weekly dose in HCC patients. Twenty‐three patients with HCC received conventional fractionated three‐dimensional conformal radiation therapy (3DCRT) were enrolled in this retrospective investigation. Among them, seven patients had been diagnosed of radiation‐induced liver disease (RILD) and the other 16 patients had good prognosis after treatment course. The cone‐beam CT (CBCT) scans were acquired once weekly for each patient throughout the treatment, deformable image registration (DIR) of planning CT (pCT) and CBCT was performed to acquire modified CBCT (mCBCT), and the structural contours were propagated by the DIR. The same plan was applied to mCBCT to perform dose calculation. Weekly dose distribution was displayed on the pCT dose space and compared using dose difference, target coverage, and dose volume histograms. Statistical analysis was performed to identify the significant dosimetric variations. Among the 23 patients, the three weekly normal liver D50 increased by 0.2 Gy, 4.2 Gy, and 4.7 Gy, respectively, for patients with RILD, and 1.0 Gy, 2.7 Gy, and 3.1 Gy, respectively, for patients without RILD. Mean dose to the normal liver (Dmean) increased by 0.5 Gy, 2.6 Gy, and 4.0 Gy, respectively, for patients with RILD, and 0.4 Gy, 3.1 Gy, and 3.4 Gy, respectively, for patients without RILD. Regarding patients with RILD, the average values of the third weekly D50 and Dmean were both over hepatic radiation tolerance, while the values of patients without RILD were below. The dosimetric consequence showed that the liver dose between patients with and without RILD were different relative to the planned dose, and the RILD patients suffered from liver dose over hepatic radiation tolerance. Evaluation of routinely acquired CBCT images during radiation therapy provides biological information on the organs at risk, and dose estimation based on mCBCT could potentially form the basis for personalized response adaptive therapy.

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“…proton beam therapy, to treat seminomas. 22,23 Although radiotherapy as an adjuvant treatment for low-grade seminoma was considered relatively safe, a significant proportion of patients develop second cancer in the radiotherapy field among other complications. 20,24 In a 2005 study collecting data from more than 40,000 patients, Travis et al were the first to raise strong evidencebased argument on radiotherapy as an independent risk factor for second malignancy after testicular cancer treatment.…”

Section: Review and Discussionmentioning

confidence: 99%

“Hockey Stick” may Strike Back: Hepatocellular Carcinoma on Noncirrhotic Liver as a Late Toxicity of Lombo-Aortic Radiotherapy for Seminoma. A Review Triggered by an Unusual Case

Korenbaum

Barthélémy

Onéa

et al. 2016

Journal of Clinical and Experimental Hepatology

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Most patients with testicular seminoma have been treated with a curative intent for decades. Second cancers after radiotherapy for testicular seminoma before 1990 are a growing issue, and are related to previous generation of dose planning and delineating strategies. Among those cancers, hepatocellular carcinoma is an extremely rare occurrence, especially when affecting patients with healthy, noncirrhotic liver. Here, we describe such a case in a patient of our institution, and subsequently review the relevant literature and large epidemiologic studies. Understanding those late and serious toxicity features may help cancer care teams to screen and treat those patients appropriately. ( J CLIN EXP HEPATOL 2016;6:54-58) M ajor improvement in testicular cancer treatment in the second half of the 20th century made it a curable disease, mainly thanks to platinum-based chemotherapy and radiation therapy. 1,2 Cancer of the testis has one of the best 5-year survival rate. 3,4 Avoiding long-term iatrogenic morbidity is now part of the treatment plan. Among the many malignancies arising from the radiotherapy field of previously treated testicular cancer patients, hepatocellular carcinoma is a rare occurrence. We describe a case of a patient presenting with in-field hepatocellular carcinoma 34 years after radiotherapy for testicular seminoma. CASE REPORTA 62-year-old man presented in April 2013 with dehydration and acute renal failure. Relevant medical history reported a left testicular seminoma in 1979, for which he underwent left orchidectomy, adjuvant platinum-based chemotherapy, and radiotherapy. Other history included transient ischemic attack in 2002. He had lost 8 kg over the past 8 months. On examination, there was no symptom of portal hypertension or chronic liver failure. Abdominal ultrasound (US) found a heterogeneous liver mass. Thoracic and abdominal computerized tomography scan (CT scan) found a 16 cm great axis tumor occupying left liver lobe almost entirely, associated with left portal thrombosis (Figure 1). The thrombus was believed to be of tumorous nature. Angio-CT scan of the liver confirmed the invasion of the left portal vein branch by the tumor. The Right liver lobe was not affected and presented normal radiological features. No distant metastases were found. Gastroscopy and colonoscopy showed no suspicious lesions. Alphafetoprotein level was 374,000 ng/mL. Other tumor markers were within normal range. Liver biopsies were performed. Pathology report came to the conclusion of a well-differentiated hepatocarcinoma (Figure 2). Liver function test were unaffected. Every major cause of cirrhosis and liver disease was ruled out including alcoholic cirrhosis, autoimmune hepatitis, hemochromatosis, Non-Alcoholic Steato-Hepatitis (NASH) or fatty liver disease, primary biliary cirrhosis, sclerosing cholangitis, and Wilson's disease. Viral serologies were negative for hepatitis B (HBs antigen and HBc antibody), hepatitis C, and cytomegalovirus (CMV), and there were no clinical suspicions of viral hepatitis. N...

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Analysis of radiation-induced liver disease using the Lyman NTCP model

Cited by 685 publications

References 28 publications

Radiation therapy for hepatocellular carcinoma

Radiation therapy for hepatocellular carcinoma

Investigation of dosimetric variations of liver radiotherapy using deformable registration of planning CT and cone‐beam CT

“Hockey Stick” may Strike Back: Hepatocellular Carcinoma on Noncirrhotic Liver as a Late Toxicity of Lombo-Aortic Radiotherapy for Seminoma. A Review Triggered by an Unusual Case

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