Assessment of Hepatic Function Decline After Stereotactic Body Radiation Therapy for Primary Liver Cancer

Publication date: Available online 17 October 2016
Source:Practical Radiation Oncology
Author(s): Diego A.S. Toesca, Evan C. Osmundson, Rie von Eyben, Jenny L. Shaffer, Albert C. Koong, Daniel T. Chang
Background and PurposeThis study aims to determine how the albumin-bilirubin (ALBI) score compares to Child-Pugh (CP) score for the assessment of liver function following SBRT.Materials and MethodsIn total, 60 patients, 40 with hepatocellular carcinoma (HCC) and 20 with cholangiocarcinoma (CCA), were treated with SBRT. Liver function panels were obtained before and at 1, 3, 6 and 12months after SBRT. Laboratory values were censored after local-regional recurrence, further liver directed therapies or liver transplant.ResultsA significant decline in hepatic function occurred after SBRT for HCC patients only (p=0.001 by ALBI score; p<0.0001 by CP score). The strongest dosimetric predictor of liver function decline for HCC was the VBED1040 using the ALBI score (p=0.07), and the VBED1020 by using the CP score (p=0.0009). For CCA patients, the VBED1040 remained the strongest dosimetric predictor using ALBI score (p=0.002), but no dosimetric predictor was significant using CP score. Hepatic function decline correlated with worse overall survival for HCC (by ALBI p=0.0005; by CP p<0.0001) and for CCA (by ALBI p=NS; by CP p=0.008).ConclusionALBI score was similarly able to predict hepatic function decline compared to CP score, and both systems correlated with survival.



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