Oxaliplatin (OX)-based chemotherapy is known to cause hepatic sinusoidal injury, resulting portal hypertension with splenomegaly (SM). We compared this OX-induced hepatopathy, SM, and their clinical significance according to combined oral fluoropyrimidines, S-1 vs. capecitabine (X) in gastric cancer (GC).
We analyzed pts from two prospective trials for GC, adjuvant XELOX (X 1000 mg/m2 bid on D1-14 + OX 130 mg/m2 on D1 q3w, 8 cycles; n = 52) and palliative SOX (S-1 40 mg/m2 bid on D1-14 + OX 130 mg/m2 on D1 q3w, continuous [SOX-c, n = 52] vs. intermittent [SOX-i, discontinuing after 6th and restarting on progression, n = 53]) Spleen volume (vol) was retrospectively measured by Rapidia software.
Baseline sex, age, ECOG PS, BSA, spleen vol, levels of platelet (plt)/liver enzyme/bilirubin (bil) and OX cumulative dose during 8 cycles did not differ in XELOX and SOX-c. After 8 cycles, the SOX-c had more SM, hepatic enhancing heterogeneity, hyper-bil, and thrombocytopenia than the XELOX (Table). The SOX-c was a risk factor for developing SM (adjusted odds ratio, 4.7; 95% CI, 2.0-10.8; p
S-1 seems to enhance OX-induced hepatic sinusoidal injuries than capecitabine in pts with GC with clinical significance of higher incidences of splenomegaly, thrombocytopenia, and hyperbilirubinemia.
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Sook Ryun Park
All authors have declared no conflicts of interest.