Successful application of whole-liver irradiation in a patient with small cell lung cancer with diffuse liver metastasis: a case report

Background Small cell lung cancer (SCLC) is an aggressive malignancy with a strong propensity for metastasis, often leading to liver metastases associated with severe hepatic dysfunction. Whole-liver irradiation (WLI) is a palliative treatment option for patients with diffuse liver metastases, especially in cases, where systemic chemotherapy is contraindicated. Case presentation We report the case of a 74-year-old Japanese man of East Asian ethnicity with extensive-disease small cell lung cancer (ED-SCLC) and diffuse liver metastases associated with severe hepatic dysfunction following first-line chemotherapy. The patient, initially deemed unsuitable for chemotherapy due to hepatic dysfunction, complained of severe abdominal distension and underwent WLI at a dose of 8 Gy in a single fraction for symptom palliation. Within 2 weeks, the patient showed significant improvement in hepatic function and symptoms. This improvement coincided with sufficient hepatic recovery to permit the subsequent administration of second-line chemotherapy. WLI may provide symptomatic relief for patients with liver metastases and may be associated with hepatic recovery sufficient to allow further systemic treatment in selected cases. Although its role is limited by liver radiation tolerance, advancements in radiotherapy techniques, such as stereotactic body radiation therapy, offer promising complementary approaches. This case highlights the potential role of WLI as a palliative option that may be associated with hepatic recovery sufficient to permit subsequent systemic therapy in selected patients with severe hepatic dysfunction caused by liver metastases. Conclusions WLI may serve as a palliative option for patients with ED-SCLC and hepatic dysfunction and, in selected cases, may be associated with hepatic recovery sufficient to permit subsequent systemic treatment. Further research is warranted to establish optimal protocols and patient selection criteria.