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RADIATION HEPATITIS INDUCED BY ABDOMINAL IRRADIATION WITH THE COBALT 60 MOVING STRIP TECHNIQUE

J. TAYLOR WHARTON M.D., LUIS DELCLOS M.D., STEVEN GALLAGER M.D., and JULIAN P. SMITH M.D.

1. Irradiation of the entire liver with doses of 2,450 to 2,920 rads given by the moving strip technique caused liver injury in 14 of 65 patients treated.

2. The clinical picture of radiation hepatitis may consist of hepatomegaly, ascites, pleural effusion, and alteration in liver function. The response to the injury sustained is variable, and patients may die within a short time (Group I). The chronic form may be a continuation of the acute injury (Group II), or the patient may experience an abrupt onset of symptoms (Group III).

3. Sinusoidal congestion, parenchymal atrophy, and subintimal fibrous thickening of the central veins are early histologic manifestations of liver injury, whereas dense fibrous occlusion of the vein lumina is a late effect.

4. A safe dose to the entire liver with the moving strip technique has not been determined. Part of the liver is no longer included in the treatment field.


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