Research progress of sinusoidal obstruction syndrome associated with oxaliplatin
Medical Statistics Department, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China; Department of Pharmacy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China
Abstract：Oxaliplatin (OXA) is the third‑generation platinum antineoplastic agents, mainly used in the treatment of metastatic colorectal cancer. Sinusoidal obstruction syndrome (SOS) is a common and serious adverse reaction of OXA. The main clinical manifestations are splenomegaly, thrombocytopenia, abnormal liver function, and portal hypertension. The mechanism is closely related to OXA‑induced oxidative stress and inflammatory reactionsin the liver, which lead to injury of hepatic sinusoidal endothelial cells, and then lead to platelet aggregation and vascular obstruction in hepatic sinusoids. The occurrence of SOS is related to the accumulated dose and the treatment cycle of OXA. Splenomegaly is an independent predictor of OXA‑related SOS. Thrombocytopenia, elevated serum hyaluronic acid and aspartate aminotrans- ferase‑to‑platelet ratio index can also predict the occurrence of SOS. OXA should be used with caution in patients with chronic liver disease, especially in those with portal hypertension. Special attention should be paid to the occurrence of SOS during OXA treatment. For patients with symptoms of suspicious SOS, imaging examination should be performed in time. Early diagnosis and timely withdrawal of drugs are bene- ficial for the reversal of liver fibrosis, and the prognosis of patients with severe fibrosis is poor.
