OCENA PARAMETRÓW BIOCHEMICZNYCH WĄTROBY PO BRACHYTERAPII PRZERZUTÓW DO WĄTROBY POD KONTROLĄ CT

Abstract

Author(s): Pawel Cisek, Izabela Kordzińska-Cisek, Lukasz Charkot, Paweł Korona, Dariusz Kieszko, Mateusz Bilski, Anna Brzozowska, Michal Janiszewski, Ludmila Grzybowska-Szatkowska

Next to thermoablation, radioembolization or chemoembolization, radiation therapy is one of non-surgical methods of local treatment for primary and secondary liver cancers. Brachytherapy is a radiotherapy technique which enables highdose irradiation with relatively low doses delivered to the remaining, healthy liver parenchyma owing to appropriate arrangement and number of applicators. The aim of the study was to assess the impact of various doses in the healthy hepatic parenchyma on early biochemical toxicity in patients undergoing brachytherapy for liver tumors. Material and methods. The analysis involved values of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (BIL) in 16 patients within the period of 6 months after brachytherapy. Six patients (37.5%) were administered 20 Gy, 7 (43.75%) 15 Gy (43.75%), and 3 (18.75%) 10 Gy. Toxicity was assessed based on the most common clinical liver function parameters: ALT, AST and BIL. Results. None of the patients demonstrated statistically significant differences in biochemical liver function markers (ALT, AST and BIL) for the first, second and third time periods. A statistically significant correlation was found between the maximum dose delivered to the liver and ALT levels in the second (p = 0.002) and third time periods (p = 0.014). Also, a correlation existed between CTV with the AST value in the first time period at a borderline significance level (p = 0.04). There were no statistically significant correlations between other physical parameters (Dmax, D1/3, D2/3, D50%, D10cm3, D100cm3, D500cm3, D100%, D90%, liver volume) and levels of biochemical liver function markers in individual time periods (p>0.05). Conclusions. Hepatotoxicity of brachytherapy depends on the volume of the irradiated tumor. This correlates with an increase in transaminases and indicates the existence of a certain tumor volume at which the toxicity of brachytherapy is not acceptable. Further studies are needed to assess the influence of brachytherapy conducted for the treatment of liver tumors on hepatotoxicity.

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