Department of Medical Oncology, University Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy.
Support Care Cancer. 2012 Jan;20(1):135-9. doi: 10.1007/s00520-010-1078-4. Epub 2011 Jan 14.
Hepatotoxicity represents a frequent chemotherapy-related side effect, often associated with course delays, discontinuations, and dose reductions. S-adenosylmethionine (AdoMet) administration is effective in the treatment of a variety of liver injuries, but it has never been evaluated in the prevention of chemotherapy-induced damage.
Seventy-eight patients affected by metastatic colorectal cancer were enrolled. Forty-two patients were treated with bevacizumab and XELOX without administering AdoMet, 32 were treated with the same regimen plus supplementation with AdoMet. Liver enzymes levels were assessed before starting the treatment, and then every therapy cycle, liver toxicity, chemotherapy course delays, discontinuations, and dose reductions due to liver toxicity were recorded.
Aspartate aminotransferase (P = 0.02), alanine transaminase (P < 0.001), lactate dehydrogenase (P = 0.008), total bilirubin (P = 0.03), and gamma-glutamyltransferase (P < 0.001) were found to be significantly lower in patients treated with AdoMet than in those who were not. Patients supplemented with AdoMet experimented a lower grade of liver toxicity (P = 0.009) and had a reduced need of course delay (P = 0.042) and dose reduction (P = 0.051).
AdoMet supplementation in patients affected by metastatic colorectal cancer treated with oxaliplatin-based regimen seems to be effective in the prevention of chemotherapy-induced liver injury.
肝毒性是化疗相关的常见副作用之一，常导致治疗进程延迟、停药和剂量减少。S-腺苷甲硫氨酸（AdoMet）在治疗多种肝损伤方面有效，但从未在预防化疗引起的肝损伤方面进行过评估。
共纳入 78 例转移性结直肠癌患者。42 例患者接受贝伐珠单抗和 XELOX 治疗，未给予 AdoMet，32 例患者接受相同方案治疗，同时补充 AdoMet。在开始治疗前和每个治疗周期后评估肝酶水平，并记录肝毒性、化疗进程延迟、停药和因肝毒性导致的剂量减少。
与未接受 AdoMet 治疗的患者相比，接受 AdoMet 治疗的患者天门冬氨酸氨基转移酶（P = 0.02）、丙氨酸氨基转移酶（P < 0.001）、乳酸脱氢酶（P = 0.008）、总胆红素（P = 0.03）和γ-谷氨酰转移酶（P < 0.001）显著降低。接受 AdoMet 补充治疗的患者肝毒性程度较低（P = 0.009），且治疗进程延迟（P = 0.042）和剂量减少（P = 0.051）的需求减少。
奥沙利铂为基础方案治疗的转移性结直肠癌患者补充 AdoMet 似乎可有效预防化疗引起的肝损伤。
