Hepatic dysfunction after radiotherapy for primary gastric lymphoma

Tanaka, Hidekazu; Hayashi, Shinya; Ohtakara, Kazuhiro; Hoshi, Hiroaki

doi:10.1093/jrr/rrs062

Cited by 7 publications

(6 citation statements)

References 21 publications

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“…They named this phenomenon ‘radiation-induced hepatic dysfunction (RIHD)’. RIHD is diagnosed in ~70% of gastric lymphoma patients after radiotherapy [ 24 ]. In our study, RIHD was observed in 37% of patients; all cases were transient and showed spontaneous improvement.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy for localized gastric mucosa–associated lymphoid tissue lymphoma: long-term outcomes over 10 years

Ohkubo

Saito

Ushijima

et al. 2017

Journal of Radiation Research

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This study aimed to assess the long-term outcomes of radiotherapy in patients with localized gastric mucosa–associated lymphoid tissue (MALT) lymphoma. Twenty-seven patients with Stage I gastric MALT lymphoma were treated with radiotherapy from 1999 to 2010. The median age was 65 years (range: 31–84). Fifteen patients were Helicobacter pylori–negative. Thirteen patients were treated with definitive radiotherapy alone. The other 14 patients who had refractory or residual disease following a prior treatment received salvage radiotherapy. The median dose of the radiotherapy was 30 Gy in 20 fractions (range: 30–39.5 Gy). The median follow-up period was 121 months (range: 8–176 months). The 5- and 10-year overall survival rates for all patients were 92% and 87%, respectively. No patients died from MALT lymphoma. Three patients died of other diseases at 8, 33 and 74 months after radiotherapy (myocardial infarction, pneumonia and hepatocellular carcinoma, respectively). No cases of local recurrence were observed during the follow-up period. There were no serious late gastric, liver or kidney complications during a median follow-up period of over 10 years. Two patients remain alive with distant metastases: a lung metastasis and an abdominal lymph node metastasis at 104 months and 21 months after radiotherapy, respectively. Excellent long-term local control was observed in patients with localized gastric MALT lymphoma after radiotherapy. However, lifelong follow-up should be conducted to detect cases of late recurrence, especially distant metastases.

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Section: Discussionmentioning

confidence: 99%

Radiotherapy for localized gastric mucosa–associated lymphoid tissue lymphoma: long-term outcomes over 10 years

Ohkubo

Saito

Ushijima

et al. 2017

Journal of Radiation Research

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“…The Eff.Vol correlation is possibly more independent from our population than the V40Gy correlation which is a kind of characteristic of our treatment protocols and related dose distributions into the liver. A similar study has been carried out in Japan (Tanaka et al, 2013) for primary gastric lymphoma treated by chemotherapy followed by radiotherapy. The level of LFT change for RILD definition was higher than in our study (2 × N versus 1.5 × N) and the probability of www.ccsenet.org/cco Cancer and Clinical Oncology Vol.…”

Section: Discussionmentioning

confidence: 90%

Correlation of Dosimetric Parameters With Subclinical Liver Function Test Alterations After Radiotherapy for Upper Gastrointestinal Tract Tumors

Malek¹,

Zhang²,

Boudam³

et al. 2014

CCO

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Purpose: To characterize conditions of radiation induced liver diseases (RILD) after radiation therapy administered for upper gastrointestinal tract tumours, not involving the liver. Method & Materials:this is a retrospective study of 169 patients treated by three dimensional conformal radiations for upper gastrointestinal tract tumours between 2002 and 2008 at the Michallon hospital. Cumulative and differential DVHs (Dose Volume Histogram) were extracted from TPS generated files and liver function tests (ALAT, ASAT, GGT and AP) and tumour markers (CA 19.9 and CEA) from patient records at four different time points (before treatment, and one, three, and six months after the end of treatment). Liver function alteration was defined as an increase in one parameter over 1.5 times the upper normal limit. All these data have been stored and statistically worked out using Lyman model parameters.Results: 34 patient records were studied. Twelve patients had RILD but none at six months. Results are consistent with the Burman description. Dosimetric profiles are different and a correlation appears between RILD and the level of doses given to liver. V40Gy is the most predictive dosimetric parameter for subclinical liver function changes. Conclusion:While dosimetric parameters are predictive of liver biological disorder, the Lyman model is not predictive of these mild disorders.

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“…However, the use of these techniques leads to an increase the dose to the liver than AP/PA, and increases the probability of hepatic toxicity. Tanaka [ 22 ] reported hepatic dysfunction of 70% after RT using 3_field or 4_field to gastric lymphoma. For patients with V 10Gy >60%, V 15Gy >50% or V 20Gy >30% of the liver, the incidence of hepatic dysfunction increased significantly.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma: dosimetric comparison and risk assessment of solid secondary cancer

Bae

Kim

et al. 2017

Radiat Oncol J

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PurposeTo determine the optimal radiotherapy technique for gastric mucosa-associated lymphoid tissue lymphoma (MALToma), we compared the dosimetric parameters and the risk of solid secondary cancer from scattered doses among anterior-posterior/posterior-anterior parallel-opposed fields (AP/PA), anterior, posterior, right, and left lateral fields (4_field), 3-dimensional conformal radiotherapy (3D-CRT) using noncoplanar beams, and intensity-modulated radiotherapy composed of 7 coplanar beams (IMRT_co) and 7 coplanar and noncoplanar beams (IMRT_non).Materials and MethodsWe retrospectively generated 5 planning techniques for 5 patients with gastric MALToma. Homogeneity index (HI), conformity index (CI), and mean doses of the kidney and liver were calculated from the dose-volume histograms. Applied the Biological Effects of Ionizing Radiation VII report to scattered doses, the lifetime attributable risk (LAR) was calculated to estimate the risk of solid secondary cancer.ResultsThe best value of CI was obtained with IMRT, although the HI varied among patients. The mean kidney dose was the highest with AP/PA, followed by 4_field, 3D-CRT, IMRT_co, and IMRT_non. On the other hand, the mean liver dose was the highest with 4_field and the lowest with AP/PA. Compared with 4_field, the LAR for 3D-CRT decreased except the lungs, and the LAR for IMRT_co and IMRT_non increased except the lungs. However, the absolute differences were much lower than <1%.ConclusionTailored RT techniques seem to be beneficial because it could achieve adjacent organ sparing with very small and clinically irrelevant increase of secondary solid cancer risk compared to the conventional techniques.

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Hepatic dysfunction after radiotherapy for primary gastric lymphoma

Cited by 7 publications

References 21 publications

Radiotherapy for localized gastric mucosa–associated lymphoid tissue lymphoma: long-term outcomes over 10 years

Radiotherapy for localized gastric mucosa–associated lymphoid tissue lymphoma: long-term outcomes over 10 years

Correlation of Dosimetric Parameters With Subclinical Liver Function Test Alterations After Radiotherapy for Upper Gastrointestinal Tract Tumors

Radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma: dosimetric comparison and risk assessment of solid secondary cancer

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