Abstract
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.
Highlights
The liver is a rather radiosensitive organ which could be either the target of radiotherapy or, most of the time, an organ at risk for a radiotherapy devoted to a nearby tumor
To characterize conditions of radiation induced liver diseases (RILD) after radiation therapy administered for upper gastrointestinal tract tumours, not involving the liver
Dosimetric profiles are different and a correlation appears between RILD and the level of doses given to liver
Summary
The liver is a rather radiosensitive organ which could be either the target of radiotherapy or, most of the time, an organ at risk for a radiotherapy devoted to a nearby tumor. This is the case for most of the abdominal or lower thoracic irradiations. Some observers have associated such alterations with visible vascular or density temporary modifications in irradiated liver regions (Sheng et al, 2010), suggesting a possible alternative origin for LFT abnormalities in patients with no sign of metastasis. Elaborating a dose-effect relationship between dose distributions to normal liver and less serious subclinical LFT alterations could help clinicians in interpreting such www.ccsenet.org/cco
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