目的：針對目前發表之幾種肝臟放射線治療後預測放射線引起之肝病變的機率模式，評估其實用性與準確性。材料與方法：1994 年 4 月至 1998 年 10 月，四位肝細胞癌病人接受三度空間隨形放射線治療後，三個月內產生放射線引起之肝病變。四位病人治療前皆接受了電腦斷層模擬定位，且影像資訊均涵蓋整個肝臟。由劑量 - 體積關係圖中求得V30Gy ，V%，Veff 與 PS 幾項參數，再由幾種預測模式換算出產生放射線引起之肝臟病變機率。 結果：四位發生放射線引起之肝病變病人中，二位死於此併發症，另二位復原。二位死於併發症的病人正常肝臟超過 30 Gy 的體積均小於 50 ％，而存活的二位病人超過 30Gy 的肝臟則大於 50 ％。四位病人中的三位其放射線劑量皆符合密西根大學醫學中心依據V50% 的建議劑量。依據正常組織併發症機率模式分析，若應用 0.69 為體積效應參數，四位病人的併發症機率均在 5 ％以下，若應用 0.32 為參數，則機率為 5-20 ％。 結論：目前發表的幾種對放射線引起之肝病變的機率預測模式，均不能準確評估臺灣肝細胞癌病人接受放射線治療後的併發症機率。 利用目前使用的放射治療療程設計及劑量 - 體積資料，建立一套適合臺灣肝細胞癌病人併發症預測模式，是有其必要性的。

　　　　　Purpose：To evaluate the feasibility and accuracy of the currentlydocumented models for prediction of radiation-induced liver disease （ RILD ）,for patients with hepatocellular carcinoma （ HCC ） treated with 3-dimensionalconformal rediotherapy. Materials and Methods： From September 1994 to October1998, four patients with HCC developed RILD within 3 months after completion of3-dimensional conformal radiotherapy. All patients had CT simulation with theimages including the entire liver. The detailed information from the dose-volumehistogram (DVH), including V30Gy, V50%, Veff and prediction score （ PS ）, werecalculated and assessed. The complication probabilities were compared withseveral documented models. Results： Two patients died of RILD-related hepaticfailure and 2 recovered. Two patients had more than half of the liver with > 30Gy survived but the other 2 patients died of RILD with 40 ％ and 23 ％ of theliver receiving >30 Gy. Three of 4 patient had the recommended doses ofradiation based on the calculated V50%. According to the normal tissuecomplication probability （ NTCP ） model, the complicatin probabilites wereless than 5 ％ and within 5-20 ％ if 0.69 and 0.32 were applied for the volumeeffect parameters, respectively.Conclusion： All the currently documented modelsfail to accurately estimate the probability of RILD for the 4 patients with HCCtreated with 3-dimensional conformal radiotherapy. It is indicated to establisha model for patients with HCC in Taiwan, using the currently availablefractionation and the information from the DVH.