The Risk Factors Of Hbv Reactivation After Conformal Radiation Therapy In Patients With Hepatocellular Carcinoma

To investigate whether conformal radiation therapy affects HBV reactivation, and the risk factors of HBV reactivation in patients with HBV-related hepatocellular carcinoma (HCC). Sixty-nine patients with HCC were included in this retrospective study. Before radiation therapy (RT), all patients underwent imaging examinations and some baseline examinations, including complete blood cell counts (CBC), liver function test, renal function test, AFP level, HBsAg, HBsAb, HBeAg, HBeAb and serum HBV DNA quantification. During the period of RT and at least 16 weeks after the end of RT, CBCs were performed weekly and the other tests were monitored monthly or more frequently if necessary. The clinical features and dosimetric parameters of RT were recorded. Univariate and multivariate Logistic regression algorithms were used to analyze the risk factors of HBV reactivation. The incidences of complications in the study population were as follows: radiation-induced liver diseases (RILD) was 17.4%, HBV reactivation was 24.6%, and HBV reactivation-induced hepatitis was 21.7%, respectively. HBV DNA level and dose volume parameters including normal liver volume, V20, and Dmean were associated with HBV reactivation. There was a relatively high incidence of HBV reactivation in HCC patients after the end of conformal RT. The serum HBV DNA level and some dosimetric parameters related to normal liver, including normal liver volume, V20, and Dmean, were the prognosis factors of HBV reactivation and should been considered carefully before conformal RT.Scientific Abstract 2384; TableMultivariate analysis of risk factors associated with HBV reactivationParametersBS.E.WaldSig.OR95% CI for ORRadiation therapy0.4360.08614.8950.2520.5911.273∼1.882HBV-DNA level0.1350.04812.4210.0011.3451.062∼1.535Normal liver volume2.1560.7497.6160.0066.5881.813∼8.790GTV0.8730.89412.9500.4350.4830.173∼2.428V5(%)1.5740.8827.3800.1933.4880.846∼9.474V10(%)2.7710.5718.6370.0743.8791.814∼15.241V20(%)1.4570.8103.0860.0364.3310.846∼11.474V30(%)1.0290.7831.7910.2241.0010.030∼8.199Dmean(Gy)1.3670.7285.1410.0015.1871.062∼4.535 Open table in a new tab