Analysis of hepatitis B virus reactivation induced by precise radiotherapy in patients with primary liver cancer

Abstract

Objective To investigate the clinical features of hepatitis B virus (HBV) reactivation after precise radiotherapy in patients with primary liver cancer (PLC) and analyze the risk factors for HBV reactivation.Methods A retrospective analysis was performed on the clinical data of 69 hepatitis B surface antigen (HBsAg)-positive patients with PLC,some of whom had HBV reactivation after precise radiotherapy.Before radiotherapy,all patients underwent baseline examinations,including blood routine,liver function test,renal function test,and quantifications of serum alpha-fetoprotein (AFP),serum HBV markers,and serum HBV DNA.During radiotherapy and within 12 weeks after radiotherapy,blood routine was performed biweekly,and liver function test,renal function test,and quantifications of serum AFP,serum HBV markers,and serum HBV DNA were performed once every four weeks.Logistic regression analysis was used to evaluate the association of the indices with HBV reactivation.Results Of the 69 patients,12 (17％) had radiation-induced liver disease,17 (25 ％) had HBV reactivation,and 15 (22％)developed hepatitis due to HBV reactivation.The logistic regression analysis showed that baseline serum HBV DNA level was the risk factor for HBV reactivation after precise radiotherapy.Conclusions HBV reactivation may occur after precise radiotherapy in patients with PLC,and baseline serum HBV DNA level is the independent risk factor for HBV reactivation.The patients who develop hepatitis due to HBV reactivation have poor prognosis even if they receive antiviral therapy in time. Key words: Liver neoplasm/three-dimensional conformal radiotherapy; Radiation-induced liver disease; Hepatitis B virus