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Intraoperative liver radiation after partial hepatectomy in a rat model
B L Eisenberg1, R M Lanciano, M L Nussbaum
1Fox Chase Cancer Center, Department of Surgery, Philadelphia, Pennsylvania 19111.
The Journal of Surgical Research
|September 1, 1992
Summary
Intraoperative radiation therapy (IORT) after liver surgery showed delayed but significant liver regeneration in rats. Doses up to 2000 cGy may be feasible for controlling residual tumors while preserving liver function.
Area of Science:
- Hepatobiliary surgery
- Radiation oncology
- Surgical oncology
Background:
- Hepatic resection is a treatment for metastatic tumors, with resection margins impacting prognosis.
- Intraoperative radiation therapy (IORT) is used in some gastrointestinal cancers, but its role after liver metastasectomy is unclear.
Purpose of the Study:
- To evaluate histological changes and DNA synthesis in rats after partial hepatectomy and liver IORT.
- To assess hepatic regenerative capacity following hepatectomy and liver IORT.
Main Methods:
- A rat model underwent partial hepatectomy and was divided into four groups: control and IORT at 1000, 2000, or 3000 cGy.
- Histological analysis (H and E staining) and DNA synthesis ([3H]-thymidine incorporation) were performed at 3, 6, and 10 days post-procedure.
- Liver weights were compared at 10 days.
Main Results:
- Higher IORT doses (3000 cGy) led to mortality and progressive hepatocyte damage.
- Diminished liver mass was observed in the 2000 and 3000 cGy groups at 10 days.
- IORT caused a dose-dependent decrease in peak DNA synthesis, with delayed but substantial regeneration observed at clinically relevant doses (1000-2000 cGy).
Conclusions:
- Liver regeneration is delayed but substantial within clinically useful IORT dose ranges (1000-2000 cGy) after resection.
- This rat model supports the feasibility of using IORT in the hepatic resection bed for patients with inadequate margins.