Anticoagulation and high dose liver radiation: a preliminary report

Area of Science:

• Hepatology
• Radiation Oncology
• Clinical Trials

Background:

• High-dose radiation to the liver can cause acute radiation hepatitis.
• The role of anticoagulation in mitigating this side effect is not well-established.

Purpose of the Study:

• To investigate the safety and efficacy of anticoagulation with warfarin in patients undergoing high-dose liver radiation.
• To assess the incidence of acute radiation hepatitis in patients receiving anticoagulation versus those who did not.

Main Methods:

• Two patient groups received high-dose liver radiation (4,050 rad whole liver or 4,000 rad to the left lobe).
• Patients were divided into those receiving warfarin anticoagulation and those not.
• Incidence of acute radiation hepatitis was monitored via clinical observation and liver scans.

Main Results:

• In the metastatic liver disease group, 1 of 9 anticoagulated patients developed radiation hepatitis versus 2 of 9 non-anticoagulated patients.
• In the Hodgkin's disease group, 1 of 4 anticoagulated patients showed changes consistent with radiation hepatitis, compared to 3 of 7 non-anticoagulated patients.
• No serious adverse events related to anticoagulation were observed in either group.

Conclusions:

• Preliminary data suggest anticoagulation with warfarin can be safely administered during high-dose hepatic radiation.
• Anticoagulation may potentially reduce the incidence of acute radiation hepatitis.
• Further clinical trials are warranted to confirm the protective role of anticoagulation in this setting.