Abstract: Objective Objective To explore the influencing factors of reactivation of hepatitis B virus (HBV) after precise radiotherapy for primary liver cancer (PLC). Methods From May 2016 to may 2019, 138 PLC patients in our hospital received precise radiotherapy.The tumor diameter, child-pugh grade of liver function, HBV DNA and other general data of patients were counted to analyze the occurrence of HBV reactivation after precise radiotherapy, and multivariate Logistic regression was used to analyze the independent influencing factors of HBV reactivation after precise radiotherapy in patients with PLC. Results All 138 PLC patients received precise radiotherapy, and 34 (24.6%) had HBV reactivation, including 6 (4.3%) at 4 weeks after precise radiotherapy, 16 (11.6%) at 8 weeks, and 12 (8.7%) at 12 weeks, all of which were included in the HBV reactivation group;104 patients (75.4%) did not experience HBV reactivation and were included in the HBV inactive group.The proportion of child-pugh grade B in the HBV reactivation group was 58.8%, significantly higher than 14.4% in the non-activated group (P<0.05);The proportion of serum HBV DNA > 1.0×10⁴ copies /ml in the HBV reactivation group was 50.0%, significantly higher than 6.7% in the non-activated group (P<0.05).Multivariate Logistic regression analysis showed that child-pugh grade (OR=1.129, 95%CI=1.004~1.270) and serum HBV DNA (OR=1.146, 95%CI=1.028~1.278) were independent influencing factors for HBV reactivation in PLC patients after accurate radiotherapy (P<0.05). Conclusion The reactivation of HBV in PLC patients after precise radiotherapy is closely related to the child Pugh grade of liver and the level of HBV DNA in serum, which should be paid more attention in clinical practice.

Key words: Precise radiotherapy, Primary liver cancer, Reactivation of hepatitis B virus, HBV DNA