Summary
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1.
The liver cells are normally nondividing but can react promptly to injury by assuming active proliferative activity.
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2.
Two main lesions are responsible for radiation-induced liver damage: (a) damage of the endothelium of the central lobular vein (VOD), and (b) direct hepatocellular damage which is expressed only upon attempt at division.
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3.
Reversible biochemical anomalies may be the only manifestation of liver injury. But progressive liver damage may occur depending on dose, volume and previous liver pathology. A dose to the whole liver not exceeding 30 Gy is generally well tolerated.
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4.
Radiation-induced liver damage may reduce the capacity of the liver to metabolize certain chemotherapeutic agents with prolongation of their half-lives and heightening of their toxicity.
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Source Material and Selected Further Reading
The Proliferation Kinetics of the Liver (Hepatopoietin, in Vitro Culure, in Vivo Transplantation Assay, Response to Injury)
Jirtle RL, Michalopoulos G, McLain JR, Crowley J (1981) Transplantation system for determining the clonogenic survival of parenchymal hepatocytes exposed to ionizing radiation. Cancer Res 41: 3512–3519.
Michalopoulos G, Cianculli HD, Novotny AR, Kligerman AD, Strom SC, Jirtle RL (1982) Liver regeneration studies with rat hepatocytes in primary culture. Cancer Res 42: 4673–4682.
Dose-Survival Curves (Radiosensitivity, in Situ Repair)
Gould MN, Clifton KH (1979) Evidence for a unique in situ component of repair of radiation damage. Radiat Res 77: 149–157.
Jirtle RL, Michalopoulos G, Strom SC, DeLuca PM, Gould MN (1984) The survival of parenchymal hepatocytes irradiated with low and high LET radiation. Br J Cancer 49 (Suppl VI): 197–201.
Thames HD, Hendry JH (1987) Fractionation in radiotherapy. Taylor Francis, London pp. 57–59.
Clinical Aspects (Pathogenesis, Clinical Syndromes, Influence of Combined Chemo-Radiotherapy)
Cassady JR, Carabell SC, Jaffe N (1979) Chemotherapy-induced related hepatic hysfunction in patients with Wilm’s tumour. Front Radiat Ther Oncol 13: 147–160.
Ingold JA, Reed GB, Kaplan HS, Bagshaw MA (1965) Radiation hepatitis. Am J Roentgenol 93: 200–208.
Ketcham A, Withers HR (1981) Gastrointestinal workshop. Cancer Clin Trials 4: 15–20.
Reed GB, Cox AJ (1966) The human liver after radiation injury: a form of veno-occlusive disease. Am J Pathol 48: 597–611.
Rubin P (1984) Late effects of chemotherapy and radiation therapy. Int J Radiat Oncol Biol Phys 10: 5–34.
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© 1990 Springer Science+Business Media Dordrecht
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Awwad, H.K. (1990). Late Reacting Normal Tissues: Radiation-Induced Liver Damage. In: Radiation Oncology: Radiobiological and Physiological Perspectives. Developments in Oncology, vol 60. Springer, Dordrecht. https://doi.org/10.1007/978-94-015-7865-3_15
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