ArticleInternational journal of radiation oncology, biology, physics2020
Dosimetric Analysis and Normal-Tissue Complication Probability Modeling of Child-Pugh Score and Albumin-Bilirubin Grade Increase After Hepatic Irradiation.
Article in International journal of radiation oncology, biology, physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Proton beam therapy indications in the Kingdom of Saudi Arabia: A SARO clinical practice guideline.Saudi medical journal · 2025Guideline
- Dosimetric superiority of proton radiosurgery in liver cancer: an in silico comparative dosimetric study.BMC cancer · 2026Article
- Normal tissue complication probability modeling of severe radiation-induced lymphopenia using blood dose for lung cancer patients treated with IMRT and IMPT.Frontiers in immunology · 2026Article
- Dose comparison of proton beam therapy with and without a multileaf collimator in the treatment of multiple hepatocellular carcinoma.Physics and imaging in radiation oncology · 2026Article
- Proton GRID and LATTICE treatment planning techniques for clinical liver SFRT treatments.Physics in medicine and biology · 2025Article
- Prospective planning comparison of magnetic resonance-guided vs. internal target volume-based stereotactic body radiotherapy of hepatic metastases - Which patients do really benefit from an MR-linac?Clinical and translational radiation oncology · 2025Article
- The use of artificial intelligence in stereotactic ablative body radiotherapy for hepatocellular carcinoma.Frontiers in medicine · 2025Review
- Evidence-based clinical recommendations for hypofractionated radiotherapy: exploring efficacy and safety - Part 4: Liver and locally recurrent rectal cancer.Radiation oncology journal · 2024Article
- The potential of integrating stereotactic ablative radiotherapy techniques with hyperfractionation for lung cancer.Thoracic cancer · 2024Article
- Do We Have a Winner? Advocating for SBRT in HCC Management.Clinical and translational radiation oncology · 2024Article
- Article
- Radiation dose is associated with improved local control for large, but not small, hepatocellular carcinomas.Radiation oncology (London, England) · 2023Article
- Predictive Model of Liver Toxicity to Aid the Personalized Selection of Proton Versus Photon Therapy in Hepatocellular Carcinoma.International journal of radiation oncology, biology, physics · 2023Article
- Study of hepatic toxicity in small liver tumors after photon or proton therapy based on factors predicting the benefits of proton.The British journal of radiology · 2023Article
- The Effect of Stereotactic Body Radiation Therapy for Hepatocellular Cancer on Regional Hepatic Liver Function.International journal of radiation oncology, biology, physics · 2023Article
- Challenges and opportunities in stereotactic body proton radiotherapy of liver malignancies.Journal of radiosurgery and SBRT · 2023Article
- Potential benefits of using radioactive ion beams for range margin reduction in carbon ion therapy.Scientific reports · 2022Article
- Machine learning-based normal tissue complication probability model for predicting albumin-bilirubin (ALBI) grade increase in hepatocellular carcinoma patients.Radiation oncology (London, England) · 2022Article
- A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity.Clinical and translational radiation oncology · 2022Article
- Predictive Modeling of Survival and Toxicity in Patients With Hepatocellular Carcinoma After Radiotherapy.JCO clinical cancer informatics · 2022Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
purposeThis study aimed to develop robust normal-tissue complication probability (NTCP) models for patients with hepatocellular carcinoma treated with radiation therapy (RT) using Child-Pugh (CP) score and albumin-bilirubin (ALBI) grade increase as endpoints for hepatic toxicity. METHODS AND MATERIALS: Data from 108 patients with hepatocellular carcinoma treated with RT between 2008 and 2017 were evaluated, of which 47 patients (44%) were treated with proton RT. Of these patients, 29 received stereotactic body RT and 79 moderately hypofractionated RT to median physical tumor doses of 43 Gy in 5 fractions and 59 Gy in 15 fractions, respectively. A generalized Lyman-Kutcher-Berman (LKB) model was used to model the NTCP using 2 clinical endpoints, both evaluated at 3 months after RT: CP score increase of ≥2 and ALBI grade increase of ≥1 from the pre-RT baseline. Confidence intervals on LKB fit parameters were determined using bootstrap resampling.
resultsCompared with previous NTCP models, this study found a stronger correlation between normal liver volume receiving low doses of radiation (5-10 Gy) and a CP score or ALBI grade increase. A CP score increase exhibited a stronger correlation to normal liver volumes irradiated than an ALBI grade increase. LKB models for CP increase found values for the volume-effect parameter of a = 0.06 for all patients, and a = 0.02/0.09 when fit to photon/proton patients separately. Subset analyses for patients with superior initial liver functions showed consistent dose-volume effects (a = 0.1) and consistent dose-response relationships.
conclusionsThis study presents an update of liver NTCP models in the era of modern RT techniques using relevant endpoints of hepatic toxicity, CP score and ALBI grade increase. The results show a stronger influence of low-dose bath on hepatic toxicity than those found in previous studies, indicating that RT techniques that minimize the low-dose bath may be beneficial for patients.
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