Potential radiotherapy-related reactivation of immune checkpoint inhibitor hepatitis
Yesmembetov K. Sahin C. Murad M. Berres M.-L. Koch A. von Websky M. Vondran F. Bruners P. Eble M. Mohamed A.A.
July 2025Springer Science and Business Media Deutschland GmbH
Strahlentherapie und Onkologie
2025#201Issue 7752 - 758 pp.
This report details the reactivation of immune checkpoint inhibitor (ICI)-related autoimmune hepatitis triggered by stereotactic body radiation therapy (SBRT) in a 55-year-old male with hilar cholangiocellular carcinoma. Initially diagnosed in December 2021, the patient underwent successful resection and subsequent adjuvant therapy. Despite stable disease following chemotherapy augmented with durvalumab, he developed grade 3 acute hepatitis after seven cycles of durvalumab. Following a brief prednisolone regimen and normalization of liver tests, SBRT targeting para-aortic lymph nodes was initiated. Remarkably, severe hepatitis reoccurred 7 days after starting SBRT, 88 days following the last durvalumab infusion, necessitating resumed and escalated prednisolone treatment. Another course of SBRT for a newly diagnosed metastatic liver lesion was administered in September 2023, with ongoing prednisolone adjustment. By February 2024, liver tests normalized, but subsequent radiological assessments indicated tumor progression, leading to the reintroduction of chemotherapy. This case underscores the potential of SBRT for activating severe immune-mediated hepatotoxicity in patients treated with ICIs, highlighting the need for careful monitoring and management of such patients. Further, this report highlights the possible survival benefit of the strategic application of SBRT in addition to systematic treatment in recurrent and metastatic cholangiocellular carcinoma.
Autoimmune hepatitis , Cholnagiocellular carcinoma , Immue checkpoint inhibitors , Immune-related adverse events , SBRT
Text of the article Перейти на текст статьи
Gastroenterology, Hepatology and infectious Diseases Department, University Hospital RWTH Aachen, Aachen, Germany
Visceral and Transplantation Surgery Department, University Hospital RWTH Aachen, Aachen, Germany
Diagnostic and interventional Radiology Department, University Hospital RWTH Aachen, Aachen, Germany
Radiation Oncology Department, University Hospital RWTH Aachen, Pauwelstraße 30, Aachen, 52074, Germany
Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), Aachen, Germany
National research oncology center, Center for Hepatopancreatobiliary Surgery and Organ Transplantation, Kerey Zhanibek khandar street 3, Astana, Z05K4F3, Kazakhstan
Gastroenterology
Visceral and Transplantation Surgery Department
Diagnostic and interventional Radiology Department
Radiation Oncology Department
Center for Integrated Oncology Aachen
National research oncology center
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026