Hepatic dysfunction after radiotherapy for primary gastric lymphoma.

Area of Science:

• Oncology
• Radiotherapy
• Hepatology

Background:

• Primary gastric lymphoma (PGL) treatment often involves three-dimensional conformal radiotherapy (3D-CRT).
• 3D-CRT may increase liver radiation dose compared to conventional methods.
• Hepatic dysfunction is a potential complication of radiotherapy.

Purpose of the Study:

• To evaluate the incidence and risk factors of radiation-induced hepatic dysfunction (RIHD) after 3D-CRT in PGL patients.
• To compare liver function before and after radiotherapy.
• To identify dose-volume parameters associated with RIHD.

Main Methods:

• Retrospective analysis of 20 PGL patients treated with 3D-CRT.
• Comparison of pre- and post-treatment liver function tests (transaminase, alkaline phosphatase).
• Analysis of liver dose-volume histograms (V5, V10, V15, V20) and mean liver dose.

Main Results:

• 19 out of 20 patients (95%) showed increased liver enzymes.
• 14 out of 20 patients (70%) developed RIHD within 4 months post-radiotherapy.
• Significant differences in liver function tests and liver dose-volume parameters were observed between patients with and without RIHD.
• High incidence of RIHD was associated with V10 > 60%, V15 > 50%, or V20 > 30%.

Conclusions:

• Hepatic dysfunction occurs frequently after 3D-CRT for PGL.
• Liver dose-volume parameters are critical predictors of RIHD.
• Radiotherapy planning should prioritize liver dose reduction to mitigate hepatic dysfunction.