Analysis of the incidence and influencing factors of radiation induced liver injury in patients with hepatitis B hepatocellular carcinoma after stereotactic radiotherapy

Abstract

Abstract: Objective To investigate the occurrence and influencing factors of radiation-induced liver injury in patients with hepatitis B hepatocellular carcinoma following stereotactic radiotherapy. Methods A retrospective analysis was conducted on the clinical data of 200 patients with hepatitis B hepatocellular carcinoma who underwent stereotactic radiotherapy at our hospital between September 2020 and September 2022. Among them, 36 patients experienced radiation-induced liver injury after treatment and were designated as the occurrence group, while the remaining 164 patients were classified as the non-occurrence group. Clinical data of the two groups were compared, and the multivariate logistic regression analysis was conducted. The study also observed the peak time, curve rising slope, and area under the curve of patients in the occurrence group before radiotherapy, 2 weeks after radiotherapy, and 4 weeks after radiotherapy. Results The proportion of patients with age >50 years old, tumor diameter >5 cm, and Child-Pugh grade C in the occurrence group (86.1%, 47.2%, 63.9%) was higher than that in the non-occurrence group (68.3%, 25.0%, 35.4%), and the white blood cell count level was [(3.5 ± 1.5) × 10⁹/L], lower than that in the non occurrence group [(5.4 ± 1.7) × 10⁹/L] (P<0.05). Multivariate logistic regression analysis revealed that age>50 years, tumor diameter>5 cm, Child Pugh grade C, and decreased white blood cell count were independent risk factors for radiation-induced liver injury in patients with hepatitis B hepatocellular carcinoma after stereotactic radiotherapy (OR=4.614, 4.968, 5.233, 5.496, P<0.05). Compared with before radiotherapy groups, the peak time of patients in the 2 week and 4 week radiotherapy groups was significantly prolonged, and the slope of curve rise and area under curve were significantly reduced (P<0.05). Conclusion Following stereotactic radiotherapy, patients with hepatitis B hepatocellular carcinoma may be at risk for radiation-induced liver injury, which is associated with older age, large tumor diameter, poor liver reserve function, and decreased white blood cell count. This warrants increased vigilance in clinical practice.

Key words: Hepatitis B hepatocellular carcinoma, Stereotactic radiotherapy, Radiation induced liver injury, influence factor

ZHOU Jin-feng, CHEN Jun-jie, ZHAN Bao-bin. Analysis of the incidence and influencing factors of radiation induced liver injury in patients with hepatitis B hepatocellular carcinoma after stereotactic radiotherapy[J]. Chinese Hepatolgy, 2024, 29(2): 193-196.

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