International Journal of Radiation Research

en Radiotherapy outcomes in NAFLD patients supported by isocaloric low-carbohydrate high-protein diet and transient elastography monitoring Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">Background: Radiotherapy-induced liver injury (RILI) is a significant complication in cancer treatment, particularly among patients with pre-existing non-alcoholic fatty liver disease (NAFLD). Non-invasive monitoring with transient elastography allows early detection of steatosis and fibrosis, while targeted nutritional support such as an isocaloric low-carbohydrate high-protein (LC-HP) diet may enhance hepatic resilience during therapy. Materials and Methods: One hundred adult NAFLD patients undergoing radiotherapy for solid tumors, mainly involving the gastrointestinal, hepatobiliary, gynecologic, and thoracic regions were prospectively enrolled in a 6-month LC-HP dietary intervention. Clinical assessments included anthropometry, biochemical markers, body composition, immune parameters, and transient elastography values [controlled attenuation parameter (CAP) and liver stiffness measurement (LSM)]. In these patients, part of the non-tumorous liver was located within the low- to moderate-dose region of the radiotherapy fields, as determined from the treatment planning data, resulting in partial hepatic irradiation. Radiotherapy data (cancer type, intent, field, and dose) were documented to contextualize hepatic exposure. Results: Despite concurrent radiotherapy, CAP and LSM values declined significantly (P < 0.05), indicating reductions in hepatic steatosis and fibrosis. BMI, waist circumference, and body fat percentage decreased, while skeletal muscle mass increased. Serum cholesterol and triglycerides decreased, prealbumin levels improved, and lymphocyte counts rose significantly (P < 0.001). These findings suggest that structured nutritional support can mitigate hepatic stress and preserve immune competence during radiotherapy. Conclusion: Integrating an isocaloric LC-HP diet with transient elastography monitoring improved hepatic, metabolic, and immune outcomes in NAFLD patients receiving radiotherapy.</div> Radiotherapy, non-alcoholic fatty liver disease, liver diseases, fatty, diet, carbohydrate-restricted, diet, high-protein, elasticity imaging techniques, liver stiffness. 663 669 http://ijrr.com/browse.php?a_code=A-10-1-1558&slc_lang=en&sid=1 T. Ye 7900319475328460034186 7900319475328460034186 No Department of Nutrition, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China S. Hou 7900319475328460034187 7900319475328460034187 No Department of Nutrition, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China C. Lin 7900319475328460034188 7900319475328460034188 No Department of Nutrition, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China M. Huang 7900319475328460034189 7900319475328460034189 No Department of Infectious Diseases, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China M. Huang 7900319475328460034190 7900319475328460034190 No Department of Outpatient, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China X. Luo lxq880@163.com 7900319475328460034191 7900319475328460034191 Yes Department of Ultrasound, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China