The Clinical Study Of Colorectal Cancer Patients' Liver Tolerance With Oxaliplatin-based Chemotherapy

Purpose:This study was performed to investigate the liver tolerance of oxaliplatin-based chemotherapy in colorectal cancer patients including liver function, platelets, spleen size and pathological changes.Methods:From March 2009 to March 2011,73 patients were treated with regular chemotherapy. Patients were assessed hematologic toxicity, liver function, and of the patients were follow-up for 12 months to observe the one-year recurrence-free survival and progression-free time.Results:Before chemotherapy, the baseline of albumin and the incidence of elevated aminotransferases and y-GT in colorectal cancer patients with liver metastasis were significantly different from patients without liver metastases:40.68g/L Vs43.41g/L, P=0.0423; 21.43% Vs2.22%, P=0.0214; 46.43% Vs15.56%, P=0.004, respectively. There was no significant difference in the baseline levels of cholinesterase, ALT and AST. After chemotherapy, Ache was significantly lower in the patients with liver metastases,5691.15IU/L Vs 4675.32IU/L, P=0.027; Decreased albumin was more likely to occur in patients with liver metastasis,42.86% Vs 17.78%, P=0.0195.â…¢/â…£elevated of AST in patients with liver metastases was higher and statistically significant, 21.43% Vs6.67%, P=0.041. The time of initial thrombocytopenia in colorectal cancer patients with liver metastasis was significantly earlier (4.07 cycle vs5.50 cycle, P=0.0408). The incidence of splenomegaly in patients without liver metastases was higher than the patients with liver metastases,44.44% Vs21.43%, P=0.0458. The incidences of neutropenia and anemia were not significantly different in the two groups. Thrombocytopenia was found to be more frequent in patients with splenomegaly,92.31% Vs48.98%, P<0.001. Among patients without liver metastasis, the recurrence rate within 1 year was 6.67%, and survival rate was 100%, while the colorectal cancer patients with liver metastases one year survival rate was 82.14% and progression-free survival time was 4.36 months. Pathological examination revealed severe sinusoidal dilatation and fatty degeneration can be found in the patients accepted neoadjuvant chemotherapy compared with the patients without chemotherapy.Conclusion:Liver tolerance was reduced after oxaliplatin-based chemotherapy, especially in the patients with liver metastasis. Severe sinusoidal dilatation and fatty degeneration occurred in patients receiving chemotherapy. The continued thrombocytopenia after oxaliplatin-containing chemotherapy is possibly due to liver damage and induced splenomegaly, a response to sinusoidal injury.