Abstract: Objective The aim of this study was to investigate the short-term efficacy of three-dimensional conformal radiotherapy (3DCRT) in patients with primary liver cancer (PLC) and to analyze the influencing factors for radiation-induced liver injury (RILI) occurrence. Methods 85 patients with PLC were encountered in our hospital between April 2019 and April 2022, and all received 3DCRT therapy. The short-term efficacy was evaluated by RECIST, and the RILI was diagnosed based on liver function tests. The multivariate Logistic regression analysis was applied to reveal the factors impacting the efficacy and the occurrence of RILI. Results After the 3D-CRT treatment, the objective remission rate (ORR) was 58.8% in our series; the percentages of TNM stage Ⅳ and Child-Pugh class B in 50 patients with objective remission were 36.0% and 14.0%, both significantly lower than 60.0% and 48.6%(P<0.05), while the percentages of single dose of 3-4 Gy and total dose of 50-60 Gy were 52.0% and 68.0%, both significantly higher than 28.6% and 45.7%(P<0.05) in those without objective remission; the prevalence of RILI was 17.7% during the 3D-CRT therapy; the percentages of TNM stage Ⅳ, Child-Pugh class B, single dose of 3-4 Gy and total dose of 50-60 Gy in 15 patients with RILI were 80.0%, 93.0%, 73.3% and 86.7%, all significantly higher than 38.6%, 14.3%, 35.7% and 52.9% (P<0.05) in 70 patients without RILI; the multivariate Logistic regression analysis showed that the TNM stage, Child-Pugh classification, single dose and total dose were all the independent risk factors impacting the efficacy and the occurrence of RILI(OR=5.078, 4.988, 4.600, 4.850, 4.963, 5.043, 5.150, 4.740, respectively, P<0.05). Conclusion The efficacy of 3DCRT treatment in patients with PLC and the occurrence of RILI are influenced by TNM staging, Child-Pugh class, single dose and total dose, so the clinicians should fully consider the above sensitive factors when making the radiotherapy plans to ensure the improved efficacy and less incidence of RILI.

Key words: Hepatoma, Three-dimensional conformal radiotherapy, Radiation- induced liver injury, Therapy, Impacting factors