Related Experiment Video
Updated: May 10, 2026
Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
Predictive factors for Child-Pugh score elevation in hepatocellular carcinoma patients treated with conformal
Jeong Il Yu1, Hee Chul Park, Do Hoon Lim
1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Aims And Background:
We designed the study to identify the clinical and dose-volumetric parameters associated with the risk of Child-Pugh score elevation in hepatocellular carcinoma patients treated with conformal radiation therapy.
Methods And Study Design:
All 161 hepatocellular carcinoma patients in the study underwent 4D-computed tomography simulation, and a dose-volume histogram was generated after radiotherapy planning. Patients who had an elevated Child-Pugh (e-CP) score of 2 or more without progressive disease within 3 months were defined as e-CP positive.
Results:
Twenty-six of 142 patients without progressive disease were e-CP positive. Pretreatment Child-Pugh class, further treatment within 30 days of radiotherapy, lymph node metastasis, mean liver dose, V(20 Gy), V(25 Gy), and V(30 Gy) were significantly correlated with e-CP positivity. The e-CP developed in 13 of 106 patients (12.3%) with V(30 Gy) of ≤28.1% and in 13 of 36 patients (36.1%) with V(30 Gy) >28.1% (P = 0.001).
Conclusions:
Our data demonstrate that mean liver dose, V(10 Gy), V(20 Gy), V(25 Gy), and V(30 Gy) are independent dose-volumetric predictors for e-CP positivity in hepatocellular carcinoma patients treated with conformal radiation therapy. V(30 Gy) should be limited to less than 28.1% to minimize the risk of e-CP.
