{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:34:23Z","timestamp":1789986863384,"version":"4.0.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP 21K07673"],"award-info":[{"award-number":["JP 21K07673"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radiation-induced liver damage (RILD) occasionally occurs following carbon-ion radiotherapy (CIRT) for liver tumors, such as hepatocellular carcinoma (HCC), in patients with impaired liver function disease. However, the associated risk factors remain unknown. The present study aimed to determine the risk factors of RILD after CIRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 108 patients with HCC treated with CIRT at the Osaka Heavy Ion Therapy Center between December 2018 and December 2022. RILD was defined as a worsening of two or more points in the Child\u2013Pugh score within 12\u00a0months following CIRT. The median age of the patients was 76\u00a0years (range 47\u201395\u00a0years), and the median tumor diameter was 41\u00a0mm (range 5\u2013160\u00a0mm). Based on the pretreatment liver function, 98 and 10 patients were categorized as Child\u2013Pugh class A and B, respectively.\u00a0We analyzed patients who received a radiation dose of 60\u00a0Gy (relative biological effectiveness [RBE]) in four fractions. The median follow-up period was 9.7\u00a0months (range 2.3\u201341.1\u00a0months), and RILD was observed in 11 patients (10.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multivariate analysis showed that pretreatment Child\u2013Pugh score B (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003, hazard ratio [HR]\u2009=\u20096.90) and normal liver volume spared from\u2009&lt;\u200930\u00a0Gy RBE (VS\n                      <jats:sub>30<\/jats:sub>\n                      \u2009&lt;\u2009739 cm\n                      <jats:sup>3<\/jats:sup>\n                      ) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009, HR\u2009=\u20095.22) were significant risk factors for RILD. The one-year cumulative incidences of RILD stratified by Child\u2013Pugh class A or B and VS\n                      <jats:sub>30<\/jats:sub>\n                      \u2009&lt;\u2009739 cm\n                      <jats:sup>3<\/jats:sup>\n                      or\u2009\u2265\u2009739 cm\n                      <jats:sup>3<\/jats:sup>\n                      were 10.3% or 51.8% and 39.6% or 9.2%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In conclusion, the pretreatment Child\u2013Pugh score and VS\n                      <jats:sub>30<\/jats:sub>\n                      of the liver are significant risk factors for RILD following CIRT for HCC.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13014-024-02444-3","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T04:02:03Z","timestamp":1713758523000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prognostic analysis of radiation-induced liver damage following carbon-ion radiotherapy for hepatocellular carcinoma"],"prefix":"10.1186","volume":"19","author":[{"given":"Kazuhiko","family":"Hayashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushi","family":"Wakisaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Ichise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Anzai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azusa","family":"Hasegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruki","family":"Teshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Fujimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"2444_CR1","doi-asserted-by":"publisher","first-page":"541","DOI":"10.6004\/jnccn.2021.0022","volume":"19","author":"AB Benson","year":"2021","unstructured":"Benson AB, D\u2019angelica MI, Abbott DE, et al. 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