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Partial irradiation of the liver
L A Dawson1, R K Ten Haken, T S Lawrence
1Department of Radiation Oncology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0010, USA. dawson@umich.edu
Seminars in Radiation Oncology
|July 12, 2001
Summary
Radiation therapy (RT) for liver tumors shows the liver has a large volume effect. Doses below 31 Gy mean liver dose have not caused radiation-induced liver disease (RILD).
Area of Science:
- Radiation Oncology
- Hepatobiliary Medicine
- Medical Physics
Background:
- Three-dimensional radiotherapy (3D-RT) and prospective patient follow-up have improved understanding of liver tolerance.
- Previous estimates of liver tolerance relied on clinical judgment, lacking quantitative data.
Purpose of the Study:
- To quantitatively assess partial liver tolerance to radiation therapy (RT).
- To refine normal tissue complication probability (NTCP) models for radiation-induced liver disease (RILD).
Main Methods:
- Fitting Lyman and local damage-organ injury (D-I) NTCP models to clinical data from over 180 patients receiving hepatic radiation.
- Analyzing patient data to identify dose thresholds and volume effects associated with RILD.
Main Results:
- The liver demonstrates a significant volume effect and a low threshold volume for RILD.
- No RILD cases were observed with a mean liver dose below 31 Gy.
- Treating less than 25% of the liver with RT may allow for higher doses without increasing RILD risk.
Conclusions:
- Quantitative analysis reveals a substantial volume effect in liver tolerance to RT.
- A mean liver dose threshold of 31 Gy is identified for RILD.
- Partial liver irradiation tolerance is dose-limited only when larger volumes of the liver are treated.