Adjuvant FOLFOX Chemotherapy and Splenomegaly in Patients with Stages II–III Colorectal Cancer
| Autor: | Eiad Nasser, Prasanna R.G. Kumar, Jeffrey Lombardo, Alan Litwin, Revathi Angitapalli, Marwan Fakih, Gregory E. Wilding, Terry Mashtare |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Organoplatinum Compounds Colorectal cancer medicine.medical_treatment Leucovorin Adenocarcinoma Gastroenterology FOLFOX Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Adjuvant therapy Humans Survival rate Aged Neoplasm Staging Retrospective Studies Chemotherapy business.industry Cancer General Medicine Middle Aged Prognosis medicine.disease Oxaliplatin Survival Rate Treatment Outcome Oncology Chemotherapy Adjuvant Splenomegaly Portal hypertension Female Fluorouracil Colorectal Neoplasms Tomography X-Ray Computed business medicine.drug |
| Zdroj: | Oncology. 76:363-368 |
| ISSN: | 1423-0232 0030-2414 |
| DOI: | 10.1159/000210025 |
| Popis: | Background: The impact of adjuvant chemotherapy on hepatic function and portal hypertension in patients with stages II–III colon cancer has not been previously described. We conducted a retrospective study to assess the effects of adjuvant FOLFOX chemotherapy on the splenic index (SI) as a surrogate marker for portal hypertension. Methods: Stage II–IIIcolorectal cancer patients treated with adjuvant FOLFOX or fluorouracil/leucovorin (5-FU/LV) at Roswell Park Cancer Institute between2002 and 2006were identified. Computerizedtomography (CT) scans obtained prior to and at completion of chemotherapy, and every 6 months thereafter were reviewed. Splenic size was evaluated using the SI (SI = length × width × height of the spleen). Results: 40 patientswere identified in the FOLFOX group and 23 in the 5-FU/LV group. After 6 months of adjuvant chemotherapy, the mean increase in SI was 45.7 and 16.3% in the FOLFOX and 5-FU/LV groups, respectively (p = 0.0069). SI increased by >100% in 6 patients (15%) in the FOLFOX group versus none in the 5-FU/LV group (p = 0.16). The mean SI at completion of adjuvant chemotherapy was significantly higher in the FOLFOX group than in the 5-FU/LV group (p = 0.007). The mean SI decreased steadily over a period of 2 years after discontinuation of FOLFOX, suggesting potential reversibility of oxaliplatin-induced hepatic injury in this setting. Conclusions: Adjuvant FOLFOX significantly increases the SI in patients with resected colorectal cancer in comparison to adjuvant 5-FU/LV. The increase in SI may be a marker of oxaliplatin-induced hepatic injury and should be investigated further in prospective longitudinal studies of oxaliplatin-based adjuvant chemotherapy. |
| Databáze: | OpenAIRE |
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