Journal of Carcinogenesis & Mutagenesis

Abstract

Oxaliplatin-Induced Sinusoidal Obstruction Syndrome: Liver Stiffness Measurement as a Novel Predictor by Elastography

Kazumi Fujioka*

Oxaliplatin is an essential component of many chemotherapies protocol for colorectal cancer and colorectal liver metastasis. The use of oxaliplatin in patients with colorectal cancer has been associated with the occurrence of the vascular hepatic lesions such as Sinusoidal Obstruction Syndrome (SOS), Nodular Regenerative Hyperplasia (NRH), and Focal Nodular Hyperplasia (FNH). It is known that SOS impairs liver function and increases morbidity and mortality. Based on the comparison between Liver Stiffness Measurement (LSM) and splenic volume index, recent study indicated that measurement of elasticity using shear wave elastography may noninvasively predict oxaliplatininduced hepatotoxicity. The recent report also provided the usefulness of MR elastography (MRE) in diagnosing SOS and determining SOS severity without contrast materials in patients with colorectal cancer. In this article, current knowledge and trends of oxaliplatin-induced SOS along with a new indicator, LSM using Ultrasonic (US) elastography and MR elastography have been reviewed. In addition, the significance and role of bevacizumab, VEGF (Vascular Endothelial Growth Factor) inhibitor have been described in oxaliplatin-based chemotherapy. As oxaliplatin is a backbone drug of many regimens for colorectal cancer and colorectal liver metastasis, oxaliplatin-based chemotherapy putatively induces SOS, NRH, and FNH. The assessment of LSM using US elastography and MR elastography may noninvasively show a predictive indicator for oxaliplatin-induced SOS. Though an association between VEGF inhibitor and atherosclerosis status has been suggested, bevacizumab may contribute to protect against the development of oxaliplatin-induced SOS.

Published Date: 2024-03-25; Received Date: 2024-02-24