Table 3 Summary of cases that developed radiation-induced liver disease after the first and second SBRT.

From: Evaluation of Hepatic Toxicity after Repeated Stereotactic Body Radiation Therapy for Recurrent Hepatocellular Carcinoma using Deformable Image Registration

Case

Timing

Pre-SBRT C–P class (score)

Dose fractionation

Normal liver volume

Cumulative MLD

Hepatotoxicity

Post-SBRT C–P class (score)

67/M

First

A (5)

60 Gy/3fx

1274 cm3

5.7 Gy

Gr 3 (AST/ALT)*

A (5)

70/M

Second

B (7)

45 Gy/3fx

1139 cm3

12.5 Gy

Gr 3 (Bilirubin)

C (12)*

58/M

Second

B (7)

45 Gy/3fx

794 cm3

19.3 Gy

Gr 2 (Bilirubin)*

B (9)*

  1. Abbreviations: SBRT, stereotactic body radiation therapy; C–P, Child–Pugh; MLD, mean liver dose; Gr, grade; AST, aspartate aminotransferase; ALT, alanine aminotransferase.
  2. *Toxicities that meet the pre-defined criteria of radiation-induced liver disease.
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