Predictors of Radiation-Induced Liver Disease in Eastern and Western Patients with Hepatocellular Carcinoma Undergoing Proton Beam Therapy

The optimal dose-volumetric indices to prevent radiation-induced liver disease (RILD) remain unclear in hepatoma patients undergoing proton beam therapy (PBT). This multi-institutional study demonstrated the unirradiated liver volume to standard liver volume ratio (ULV/SLV) as the most crucial RILD predictor. Distinct from photon radiotherapy, mean liver dose is not an independent RILD determinant. Our results indicate that doses ≥1 GyE could cause hepatic complications, and preserving sufficient ULV/SLV is imperative to prevent RILD in PBT.

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