Effect of Therapeutic Irradiation of Carcinoma of Cervix on Liver Function

Abstract

variety of pathologic states, including that resulting from exposure to ionizing radiations, it was thought desirable serially to observe changes in the hepatic tests of patients undergoing therapeutic radiation for cancer.In the voluminous literature dealing with the systemic results of irradiation we were able to find no systematic studies of liver function and little unanimity on the presence or absence of hepatic participation in the systemic reaction to irradiation. In most discussions of the relative radiosensitivity of various tissues the liver is described as being radioresistant, though occasional reports suggest the opposite. As examples of the latter, Ellinger 1 has stated that the liver is exceedingly radiosensitive (increased urobilinogenuria after ordinary fluoroscopic examination) and Levitt2 has mentioned that patients with liver disease tolerate radiation poorly, exhibiting severe constitutional symptoms when exposed to doses which commonly produce no untoward reactions in patients free of liver dysfunction.In radiation therapy, especially when multiple beams are used, much of the radiation absorbed is not delivered to the tumor region itself but to the surrounding normal tissue. This radiation contributes not to the destruction of the tumor but to the injury of the normal tissues of the tumor bed and if excessive may even inhibit healing processes following tumor modification. It seems reasonable to assume that the constitutional effects of radiation are, in part at least, a function of the total energy absorbed by the body during the course of treatment rather than of the tumor dose.