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Updated: Sep 18, 2025

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Risk Factors of Non-Classic Radiation-Induced Liver Disease (ncRILD) After Intensity-Modulated Radiotherapy in
You-Qin Du1,2, Su-Ping Tao3, Jian-Xu Li1
1Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.
Purpose:
This study aimed to identify independent risk factors for non-classic radiation-induced liver disease (ncRILD) in hepatocellular carcinoma (HCC) patients treated with intensity-modulated radiation therapy (IMRT) and to construct a predictive nomogram.
Patients And Methods:
We retrospectively analyzed 177 primary HCC patients treated with IMRT between 2013 and 2021. Univariate and multivariate analyses were conducted to identify risk factors for ncRILD. A nomogram was developed based on significant variables. Dosimetric parameters were also assessed across different fractionation doses.
Results:
Multivariate analysis identified tumor number ≥ 2, mean liver dose ≥ 1371.4 cGy, and normal liver volume < 700 mL as independent risk factors for ncRILD. A nomogram was established using logistic regression. In patients receiving ≥ 4 Gy per fraction, ncRILD was significantly associated with Vs5-Vs40 (p < 0.05), but not with V5-V40. No such associations were found for 2 Gy and 3 Gy groups.
Conclusion:
Patients with multifocal tumor, lower normal liver volume and higher mean liver dose are at increased risk of developing radiation-induced liver injury. These findings suggest that dosimetric parameters, especially at higher fraction doses, may play a critical role in the occurrence of ncRILD.
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