s-1-(combination) and Hepatic-Veno-Occlusive-Disease

Oxaliplatin-based chemotherapy is associated with hepatic sinusoidal obstruction syndrome (SOS).. We analyzed patients from two prospective trials, in which capecitabine/oxaliplatin (XELOX, 8 cycles; n=51) and S-1/oxaliplatin [SOX, continuous (SOX-C, n=50), or intermittent (discontinuation after cycle 6 and restart on progression, SOX-I, n=50)] were administered. We compared severity (splenomegaly, thrombocytopenia, liver enzyme levels, and hepatic parenchymal heterogeneity), clinical significance (delay or dose-reduction of chemotherapy), and reversibility of SOS (splenomegaly and thrombocytopenia after stopping chemotherapy) between SOX and XELOX in gastric cancer patients.. SOX was more likely to be associated with splenomegaly, thrombocytopenia, hyperbilirubinemia, and hepatic parenchymal heterogeneity than XELOX. Splenomegaly was partially reversible after stopping chemotherapy in both regimens, but recovery rate was lower in SOX. Proportion of delayed or dose-reduced chemotherapy cycles due to thrombocytopenia was significantly higher in SOX-C than in XELOX.. S-1 combination is more likely to worsen oxaliplatin-induced hepatic sinusoidal injuries than capecitabine in gastric cancer patients.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Biomarkers; Capecitabine; Disease Management; Drug Combinations; Female; Hepatic Veno-Occlusive Disease; Humans; Incidence; Liver Function Tests; Male; Middle Aged; Oxaliplatin; Oxonic Acid; Retrospective Studies; Spleen; Splenectomy; Stomach Neoplasms; Tegafur; Treatment Outcome

A 62-year-old man was diagnosed with liver metastasis of sigmoid colon cancer, which resulted in bowel obstruction. SOX plus bevacizumab therapy was administered to perform hepatectomy, after the artificial anus construction; however, substantial liver dysfunction occurred. Therefore, we only performed primary tumor resection and waited for improvement in liver function. After 2 months, liver function improved and liver metastasis increased. However, another metastasis was not recognized, so hepatectomy was carried out, and R0 resection was performed. The oxaliplatin-induced liver function disorder was reversible; however, preoperative chemotherapy for resectable colorectal liver metastases increases the risk of missing the resection window. It is necessary to carefully examine the tumor type and preoperative liver function.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Drug Combinations; Hepatectomy; Hepatic Veno-Occlusive Disease; Humans; Liver; Liver Neoplasms; Male; Middle Aged; Organoplatinum Compounds; Oxaliplatin; Oxonic Acid; Sigmoid Neoplasms; Tegafur