{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:01:27Z","timestamp":1790845287445,"version":"4.1.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":85,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small cell lung cancer (SCLC) is an aggressive malignancy with a strong propensity for metastasis, often leading to liver metastases associated with severe hepatic dysfunction. Whole-liver irradiation (WLI) is a palliative treatment option for patients with diffuse liver metastases, especially in cases, where systemic chemotherapy is contraindicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a 74-year-old Japanese man of East Asian ethnicity with extensive-disease small cell lung cancer (ED-SCLC) and diffuse liver metastases associated with severe hepatic dysfunction following first-line chemotherapy. The patient, initially deemed unsuitable for chemotherapy due to hepatic dysfunction, complained of severe abdominal distension and underwent WLI at a dose of 8\u00a0Gy in a single fraction for symptom palliation. Within 2\u00a0weeks, the patient showed significant improvement in hepatic function and symptoms. This improvement coincided with sufficient hepatic recovery to permit the subsequent administration of second-line chemotherapy. WLI may provide symptomatic relief for patients with liver metastases and may be associated with hepatic recovery sufficient to allow further systemic treatment in selected cases. Although its role is limited by liver radiation tolerance, advancements in radiotherapy techniques, such as stereotactic body radiation therapy, offer promising complementary approaches. This case highlights the potential role of WLI as a palliative option that may be associated with hepatic recovery sufficient to permit subsequent systemic therapy in selected patients with severe hepatic dysfunction caused by liver metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>WLI may serve as a palliative option for patients with ED-SCLC and hepatic dysfunction and, in selected cases, may be associated with hepatic recovery sufficient to permit subsequent systemic treatment. Further research is warranted to establish optimal protocols and patient selection criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13256-026-06340-0","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T09:34:05Z","timestamp":1783503245000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful application of whole-liver irradiation in a patient with small cell lung cancer with diffuse liver metastasis: a case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1638-0033","authenticated-orcid":false,"given":"Takahiro","family":"Ogasawara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Toi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Yamazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Doman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Minami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akane","family":"Narumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Odaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Ono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Sugisaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoiki","family":"Aiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Kawana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsuke","family":"Yamanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misako","family":"Miwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunichi","family":"Sugawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"6340_CR1","doi-asserted-by":"publisher","first-page":"2466","DOI":"10.3748\/wjg.v12.i15.2466","volume":"12","author":"K Kaira","year":"2006","unstructured":"Kaira K, Takise A, Watanabe R, Mori M. Fulminant hepatic failure resulting from small-cell lung cancer and dramatic response of chemotherapy. World J Gastroenterol. 2006;12:2466\u20138. https:\/\/doi.org\/10.3748\/wjg.v12.i15.2466.","journal-title":"World J Gastroenterol"},{"key":"6340_CR2","first-page":"495","volume":"37","author":"T Tokito","year":"2010","unstructured":"Tokito T, Ichiki M, Sakata S, Nakamura M, Inoue Y, Wada Y, et al. A case of small cell lung cancer (extensive disease) with liver metastasis acquiring stable disease by hepatic arterial infusion chemotherapy. 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Written informed consent was obtained from the patient for publishing this case report and the accompanying images.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal upon request.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Yukihiro Toi received personal fees from AstraZeneca, Chugai Pharma, Pfizer, Taiho Pharmaceutical, Kyowa Kirin, Bristol-Myers Squibb, Ono Pharmaceutical, and MSD K.K. Shinsuke Yamada received personal fees from AstraZeneca, Novartis, Sanofi, GSK, and Nippon Boehringer Ingelheim. Shunichi Sugawara received personal fees from AstraZeneca, Chugai Pharma, Pfizer, Taiho Pharmaceutical, Eli Lilly, Novartis, Kyowa Kirin, Bristol-Myers Squibb, Ono Pharmaceutical, MSD K.K., and Nippon Boehringer Ingelheim. These relationships did not influence the clinical decision-making or data interpretation in this case report. All other authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"582"}}