Motoori Shigeatsu, Kawase Takashi, Nishimura Hitoshi, Hosokawa Yuko, Konno Tomoko, Hanai Chizuko, Kitagawa Naoko, Saisho Hiromitsu, Furuse Junji
Dept. of Internal Medicine and Clinical Oncology, Kaken Hospital, Japan.
Gan To Kagaku Ryoho. 2011 Apr;38(4):677-80.
Hepatic sinusoidal injury arises occasionally after oxaliplatin-based chemotherapy. As a result, portal hypertension associated with splenomegaly occurs in some cases. We report two cases of advanced colorectal cancer which showed splenomegaly after administration of oxaliplatin-based chemotherapy. In both cases, mFOLFOX6/bevacizumab was administered as a firstline chemotherapy. Splenic volume was determined by loading the CT images onto a commercially available workstation. In case 1, initial splenic volume was 137.82mL. Two months later, it increased to 160.96mL. After six cycles of chemotherapy, we removed oxaliplatin due to peripheral neuropathy. Consequently, the splenic volume decreased to 151.58mL. Subsequent to the reintroduction of oxaliplatin, the splenic volume increased to 177.48mL. Following two cycles of mFOLFOX6/bevacizumab, oxaliplatin was removed again. In a similar way, splenic volume decreased to 158.52mL. In case 2, initial splenic volume was 105.84mL. Ten months later, it increased to 228.54mL. After administration of mFOLFOX6/bevacizumab, we continued chemotherapy with sLV5FU2/bevacizumab and irinotecan. The splenic volume decreased to 197. 06mL. In conclusion, oxaliplatin- based chemotherapy induces an increase in splenic volume, however, it may be reversible after discontinuation of oxaliplatin.
基于奥沙利铂的化疗后偶尔会出现肝窦损伤。因此，部分病例会发生与脾肿大相关的门静脉高压。我们报告两例晚期结直肠癌患者，他们在接受基于奥沙利铂的化疗后出现了脾肿大。在这两例病例中，均采用mFOLFOX6/贝伐单抗作为一线化疗方案。通过将CT图像加载到商用工作站上测定脾脏体积。病例1中，初始脾脏体积为137.82mL。两个月后，脾脏体积增加至160.96mL。化疗六个周期后，由于外周神经病变停用奥沙利铂。结果，脾脏体积降至151.58mL。重新使用奥沙利铂后，脾脏体积增至177.48mL。在接受两个周期的mFOLFOX6/贝伐单抗治疗后，再次停用奥沙利铂。同样，脾脏体积降至158.52mL。病例2中，初始脾脏体积为105.84mL。十个月后，脾脏体积增加至228.54mL。在给予mFOLFOX6/贝伐单抗后，我们继续使用sLV5FU2/贝伐单抗和伊立替康进行化疗。脾脏体积降至197.06mL。总之，基于奥沙利铂的化疗会导致脾脏体积增大，然而，在停用奥沙利铂后脾脏体积增大可能是可逆的。
