Is liver radiotherapy contraindicated in patients with Child-Pugh C liver function?
I think one should be very cautious with regards to radiation for this group, whether palliative or definitive. The CPC patient has a very poor prognosis with a 2 year expected survival of only 30%. We have learned that patients with CPB liver disease, especially those with scores of 8 and above, ar...
I agree with Tracey totally. A recent study from Indiana University (published in PRO by Lasley and Cardenes) showed that with CPB patients, low dose spillage as low as 2.5 Gy in 5 fxs impacted on the risk of hepatic toxicity. CPC patients are expected to be worse off. That begs the question whether...
We have an IRB approved retrospective review of patients we treated with SBRT to 50 Gy using 5 fraction SBRT with CTP C disease at OHSU. Our manuscript is currently undergoing revision and we hope to have it published sometime soon! We are hopeful these findings will advance this discussion.
We have a very active liver SBRT program at our VA hospital, and working closely with our HCC and liver txp teams have learned to be mindful of frail patients. Child's Pugh C pts are typically dying. We need to remember that tolerance to radiotherapy, including high doses, requires a level of physio...