Side effects during/soon after treatment (Early or ‘acute’ side effects)
Acute side effects usually set in after the first few treatments and settle weeks after the treatment course.
General – Fatigue is common for most patients receiving radiation therapy. The severity of fatigue is variable between patients. Many patients return to a normal level of activity within a few weeks after the completion of radiation therapy.
Local – Nausea with or without vomiting is uncommon but can occur as the small bowel is sensitive to radiation therapy. The small bowel surrounds the liver, and a small dose of radiation therapy can trigger nausea in some patients.
Chest wall pain is uncommon but can occur if the chest wall receives a sufficient dose of radiation therapy.
Some patients may experience swelling of the abdomen from fluid build-up inside the abdomen.
What can help reduce side effects?
Resting can help with fatigue, and most other side effects can be alleviated with oral medications.
Side effects well after treatment (Long-term or ‘late’ side effects)
Late side effects develop few months or years after the treatment course, but they are uncommon.
Local – Liver SBRT may weaken parts of the ribs and can cause chest wall pain and, on rare occasions, rib fractures. Although extremely uncommon, liver SBRT can cause stomach or duodenal ulcer and bleeding.
Within three months following SBRT, the liver may become enlarged, the abdomen can swell from fluid build-up, and blood tests may show a worsening in liver function. This condition is called radiation-induced liver disease (RILD), and the risk of developing this problem is less than 5 in 100.
There is a slightly higher risk of developing “nonclassic RILD,” which includes the reactivation of viral hepatitis, and blood tests showing a worsening liver function. For liver cancers located in the centre of the liver, there is a very small risk of developing narrow bile ducts.
What can be done to treat late side effects?
Patients treated with liver SBRT will have regular follow-up appointments. At each appointment, a liver specialist and or radiation oncologist will request a blood test to evaluate the liver health. It is routine for patients to have regular scans (MRI and or CT) to assess treatment response, and also to look for new suspicious masses within the liver. If you develop any worrying symptoms described above, please do not hesitate to contact your medical team.