Tsuji Kunihiro, Doyama Hisashi
Kunihiro Tsuji, Hisashi Doyama, Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa 920-8530, Japan.
World J Gastrointest Oncol. 2017 Aug 15;9(8):314-318. doi: 10.4251/wjgo.v9.i8.314.
To determine whether S-1 induces hepatic steatosis in patients being treated for pancreatic cancer.
This retrospective study evaluated 22 patients who received oral S-1 as a first-line treatment for pancreatic cancer between January 2008 and July 2015 at the Ishikawa Prefectural Central Hospital. Patients underwent abdominal computed tomography (CT) scans before chemotherapy and within 3 mo from the start of treatment. CT numbers of the liver and spleen were measured before and after S-1 administration. Steatosis was diagnosed when the ratio of the CT number of the liver to that of the spleen (liver/spleen ratio) was < 0.9.
Median patient age was 68 years (range, 48-85 years), and median body mass index was 21 kg/m (range, 18-27 kg/m). Of the 22 patients, six (27%) regularly consumed alcohol, and five (23%) had liver metastases. The mean ratio of CT number of the liver to the spleen was significantly higher before administration of S-1 (1.27 1.09, = 0.012) compared with after. Of the 22 patients, five (23%) had hepatic steatosis and 17 (77%) did not. The pretreatment demographic and clinical characteristics of these two groups showed no significant differences. The relationship between liver/spleen ratio and alanine transaminase activity in these patients. A statistically significant inverse correlation was observed ( = -0.417, < 0.027).
Of the 22 patients with pancreatic cancer, five (23%) experienced S-1 induced hepatic steatosis. Care should be taken during S-1 treatment of patients with pancreatic cancer.
确定S-1是否会在接受胰腺癌治疗的患者中诱发肝脂肪变性。
这项回顾性研究评估了2008年1月至2015年7月期间在石川县立中央医院接受口服S-1作为胰腺癌一线治疗的22例患者。患者在化疗前及治疗开始后3个月内接受腹部计算机断层扫描(CT)。在给予S-1前后测量肝脏和脾脏的CT值。当肝脏CT值与脾脏CT值之比(肝/脾比)<0.9时诊断为脂肪变性。
患者中位年龄为68岁(范围48 - 85岁),中位体重指数为21 kg/m²(范围18 - 27 kg/m²)。22例患者中,6例(27%)经常饮酒,5例(23%)有肝转移。与给药后相比,给予S-1前肝脏与脾脏CT值的平均比值显著更高(1.27±1.09,P = 0.012)。22例患者中,5例(23%)有肝脂肪变性,17例(77%)没有。这两组患者治疗前的人口统计学和临床特征无显著差异。这些患者中肝/脾比与丙氨酸转氨酶活性之间的关系。观察到具有统计学意义的负相关(r = -0.417,P < 0.027)。
在22例胰腺癌患者中,5例(23%)出现S-1诱发的肝脂肪变性。在胰腺癌患者的S-1治疗过程中应予以注意。