Does adjuvant radiotherapy suppress liver regeneration after partial hepatectomy?
OBJECTIVE
To analyze the influence of the adjuvant radiotherapy (RT) on the liver regeneration and liver function after partial hepatectomy (PH).


METHODS
Thirty-four patients who underwent PH for biliary tract cancer between October 2003 and July 2005 were reviewed. Hemihepatectomy was performed in 14 patients and less extensive surgery in 20. Of the patients, 19 patients had no adjuvant therapy (non-RT group) and 15 underwent adjuvant RT by a three-dimensional conformal technique (RT group). Radiation dose range was 40 to 50 Gy (median, 40 Gy). Liver volume on computed tomography and the results of liver function tests at 1, 4, 12, 24, and 52 weeks after PH were compared between the RT and non-RT groups.


RESULTS
The preoperative characteristics were identical for both groups. During the interval between Weeks 4 and 12 when adjuvant RT was delivered in the RT group, the increase in liver volume was significantly smaller in the RT group than non-RT group (22.9 +/- 38.3cm(3) and 81.5 +/- 75.6cm(3), respectively, p = 0.007). However, the final liver volume measured at 1 year after PH did not differ between the two groups (p = 0.878). Liver function tests were comparable for both groups. The resection extent and original liver volume was independent factors for final liver volume measured at 1 year after PH.


CONCLUSIONS
In this study, adjuvant RT delayed the liver regeneration process after PH, but the volume difference between the two study groups became nonsignificant after 1 year. Adjuvant RT had no additional adverse effect on liver function after PH.
Choi
Jin-Hwa
JH
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
Kim
Kyubo
K
Chie
Eui Kyu
EK
Jang
Jin-Young
JY
Kim
Sun Whe
SW
Oh
Do-Youn
DY
Im
Seock-Ah
SA
Kim
Tae-You
TY
Bang
Yung-Jue
YJ
Ha
Sung W
SW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000704:Analysis of Variance; D001219:Aspartate Aminotransferases / Q000097:blood; D001661:Biliary Tract Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000254:growth & development / Q000502:physiology / Q000528:radiation effects; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000528:radiation effects; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D020266:Radiotherapy, Conformal / Q000379:methods; D047368:Tumor Burden
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase