Prediction of radiation-induced liver disease by Lyman normal-tissue complication probability model in three-dimensional conformal radiation therapy for primary liver carcinoma.
OBJECTIVE
To describe the probability of RILD by application of the Lyman-Kutcher-Burman normal-tissue complication (NTCP) model for primary liver carcinoma (PLC) treated with hypofractionated three-dimensional conformal radiotherapy (3D-CRT).


METHODS
A total of 109 PLC patients treated by 3D-CRT were followed for RILD. Of these patients, 93 were in liver cirrhosis of Child-Pugh Grade A, and 16 were in Child-Pugh Grade B. The Michigan NTCP model was used to predict the probability of RILD, and then the modified Lyman NTCP model was generated for Child-Pugh A and Child-Pugh B patients by maximum-likelihood analysis.


RESULTS
Of all patients, 17 developed RILD in which 8 were of Child-Pugh Grade A, and 9 were of Child-Pugh Grade B. The prediction of RILD by the Michigan model was underestimated for PLC patients. The modified n, m, TD50 (1) were 1.1, 0.28, and 40.5 Gy and 0.7, 0.43, and 23 Gy for patients with Child-Pugh A and B, respectively, which yielded better estimations of RILD probability. The hepatic tolerable doses (TD5) would be MDTNL of 21 Gy and 6 Gy, respectively, for Child-Pugh A and B patients.


CONCLUSIONS
The Michigan model was probably not fit to predict RILD in PLC patients. A modified Lyman NTCP model for RILD was recommended.
Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai, China.
Zhi-Yong
ZY
Xu
Shi-Xiong
SX
Liang
Ji
J
Zhu
Xiao-Dong
XD
Zhu
Jian-Dong
JD
Zhao
Hai-Jie
HJ
Lu
Yun-Li
YL
Yang
Long
L
Chen
An-Yu
AY
Wang
Xiao-Long
XL
Fu
Guo-Liang
GL
Jiang
D000328:Adult; D000368:Aged; D016461:Chemoembolization, Therapeutic / Q000379:methods; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016013:Likelihood Functions; D008099:Liver / Q000528:radiation effects*; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015233:Models, Statistical; D011832:Radiation Injuries / Q000209:etiology*; D011836:Radiation Tolerance; D020266:Radiotherapy, Conformal / Q000009:adverse effects*