Radiotherapy shows excellent local control in liver cancers but carries the risk of radiation-induced liver dysfunction and liver failure. We conducted a study of plasma hepatocyte growth factor (HGF) in a clinical trial of proton radiotherapy in patients with unresectable liver cancers (NCT00976898), and in an observational study for liver cancer patients undergoing surgical treatments. Liver dysfunction within 3 months after radiotherapy—a Childs−Turcotte−Pugh (CTP) score increase of 1 point or more—occurred in 9/34 (26%) of patients. Patients with no increase in CTP score had lower pretreatment plasma HGF level (p = 0.015). Both the increase in CTP score (p = 0.034) and the pretreatment plasma HGF (p = 0.017) were associated with OS. Plasma HGF was significantly associated with presence of cirrhosis (p = 0.0027) and with Model for End-stage Liver Disease (MELD) score (p < 0.0001), but not with OS in surgical liver cancer patients. Pretreatment plasma HGF is a candidate biomarker for patient selection for radiotherapy.

放射疗法在肝癌中显示出出色的局部控制能力，但存在放射线诱发的肝功能障碍和肝衰竭的风险。我们在质子放疗对无法切除的肝癌患者的临床试验（NCT00976898）中进行了血浆肝细胞生长因子（HGF）的研究，并对正在进行手术治疗的肝癌患者进行了观察性研究。9/34（26％）的患者在放疗后3个月内出现肝功能不全（Childs-Turcotte-Pugh（CTP）评分提高了1分或更多）。CTP评分未升高的患者治疗前血浆HGF水平较低（p  = 0.015）。CTP评分增加（p  = 0.034）和治疗前血浆HGF（p = 0.017）与OS相关联。血浆HGF与肝硬化的存在显着相关（p  = 0.0027）和 晚期肝病模型（MELD）评分（p <0.0001），但在外科手术肝癌患者中与OS无关。预处理血浆HGF是用于放射治疗患者选择的候选生物标志物。