Radiation-Induced Liver Disease and Modern Radiotherapy

• Published in: Seminars in radiation oncology Vol. 28; no. 4; pp. 321 - 331
• Main Authors: Koay, Eugene J., Owen, Dawn, Das, Prajnan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2018
• Subjects: Dose-Response Relationship, Radiation; Humans; Liver - radiation effects; Liver Diseases - etiology; Liver Neoplasms - radiotherapy; Radiation Injuries - etiology; Radiometry; Radiotherapy - adverse effects; Risk Factors
• ISSN: 1053-4296; 1532-9461
• DOI: 10.1016/j.semradonc.2018.06.007

Modern radiotherapy techniques have enabled high focal doses of radiation to be delivered to patients with primary and secondary malignancies of the liver. The current clinical practice of radiation oncology has benefitted from decades of research that have informed how to achieve excellent local control and survival outcomes with minimal toxicities. Still, one of the most devastating consequences of radiation to the liver remains a challenge: radiation-induced liver disease (RILD). Here, we will review the current understanding of classic and nonclassic RILD from a clinical perspective, the evaluation and management of patients who are at risk of developing RILD, methods to reduce the likelihood of RILD using modern radiation techniques, and the diagnosis and treatment of radiation-related liver toxicities.