Abstract：
OBJECTIVE: Oxaliplatin can lead to hepatic sinusoidal injury, called hepatic sinusoidal obstruction syndrome (SOS), resulting in portal hypertension-related complications. This could worsen the clinical course of the patients treated with oxaliplatin. Early diagnosis is challenging. We explored predictive markers of oxaliplatin-induced collateral vessels.
METHODS: Patients who received oxaliplatin-based chemotherapy were retrospectively screened. We evaluated their laboratory findings and spleen size on computed tomography immediately before oxaliplatin-based chemotherapy and after 6 months of treatment. The primary outcome was collateral vessel development, as a surrogate marker for oxaliplatin-induced SOS in patients who underwent oxaliplatin-based chemotherapy. The secondary outcome was the identification of factors that predicted the development of collateral vessels.
RESULTS: We enrolled 161 patients who received oxaliplatin-based chemotherapy. They had a median age of 69 years, and 63.3% were men. Collateral vessels developed in nine (5.6%) patients during the study period. After oxaliplatin-based chemotherapy, the spleen size increased in 104 patients (64.6%), with a ≥ 30% increase in 19.4% of the patients. Univariate analysis showed that the Fibrosis-4 (FIB-4) index (≥ 1.76; OR 9.17), aspartate aminotransferase:platelet ratio index (APRI) (≥ 0.193; OR 9.62), cumulative dose of oxaliplatin (≥ 1000 mg; OR 8.43), and increase in spleen size (≥ 30%; OR 6.01) were significant risk factors for collateral vessel development. Multivariate analysis after stepwise selection revealed that the FIB-4 index and spleen size were significant independent predictive factors.
CONCLUSIONS: A ≥ 1.76 increase in the FIB-4 index and a ≥ 30% increase in spleen size after 6 months of oxaliplatin-based chemotherapy were significant predictive markers for collateral vessel development.
METHODS: Patients who received oxaliplatin-based chemotherapy were retrospectively screened. We evaluated their laboratory findings and spleen size on computed tomography immediately before oxaliplatin-based chemotherapy and after 6 months of treatment. The primary outcome was collateral vessel development, as a surrogate marker for oxaliplatin-induced SOS in patients who underwent oxaliplatin-based chemotherapy. The secondary outcome was the identification of factors that predicted the development of collateral vessels.
RESULTS: We enrolled 161 patients who received oxaliplatin-based chemotherapy. They had a median age of 69 years, and 63.3% were men. Collateral vessels developed in nine (5.6%) patients during the study period. After oxaliplatin-based chemotherapy, the spleen size increased in 104 patients (64.6%), with a ≥ 30% increase in 19.4% of the patients. Univariate analysis showed that the Fibrosis-4 (FIB-4) index (≥ 1.76; OR 9.17), aspartate aminotransferase:platelet ratio index (APRI) (≥ 0.193; OR 9.62), cumulative dose of oxaliplatin (≥ 1000 mg; OR 8.43), and increase in spleen size (≥ 30%; OR 6.01) were significant risk factors for collateral vessel development. Multivariate analysis after stepwise selection revealed that the FIB-4 index and spleen size were significant independent predictive factors.
CONCLUSIONS: A ≥ 1.76 increase in the FIB-4 index and a ≥ 30% increase in spleen size after 6 months of oxaliplatin-based chemotherapy were significant predictive markers for collateral vessel development.
摘要：
目的：奥沙利铂可导致肝窦损伤，称为肝窦阻塞综合征（SOS），导致门静脉高压相关并发症。这可能使奥沙利铂治疗的患者的临床过程恶化。早期诊断具有挑战性。我们探索了奥沙利铂诱导的侧支血管的预测标志物。
方法：对接受奥沙利铂为基础化疗的患者进行回顾性筛查。我们在基于奥沙利铂的化疗前和治疗6个月后立即在计算机断层扫描上评估了他们的实验室发现和脾脏大小。主要结果是侧支血管发育，在接受以奥沙利铂为基础的化疗的患者中，作为奥沙利铂诱导的SOS的替代指标。次要结果是确定预测侧支血管发展的因素。
结果：我们招募了161名接受奥沙利铂为基础化疗的患者。他们的平均年龄为69岁，63.3%是男性。在研究期间，有9名（5.6％）患者出现了侧支血管。在以奥沙利铂为基础的化疗后，104例(64.6%)患者脾脏大小增加,19.4%的患者增加≥30%。单因素分析显示，纤维化-4（FIB-4）指数（≥1.76；OR9.17），天冬氨酸氨基转移酶：血小板比率指数（APRI）（≥0.193；OR9.62），奥沙利铂的累积剂量（≥1000mg；OR8.43），脾脏大小增加(≥30%;OR6.01)是侧支血管发育的显著危险因素。多因素分析显示，FIB-4指数和脾脏大小是显著的独立预测因素。
结论：基于奥沙利铂的化疗6个月后，FIB-4指数增加≥1.76和脾脏大小增加≥30%是侧支血管发育的重要预测指标。
方法：对接受奥沙利铂为基础化疗的患者进行回顾性筛查。我们在基于奥沙利铂的化疗前和治疗6个月后立即在计算机断层扫描上评估了他们的实验室发现和脾脏大小。主要结果是侧支血管发育，在接受以奥沙利铂为基础的化疗的患者中，作为奥沙利铂诱导的SOS的替代指标。次要结果是确定预测侧支血管发展的因素。
结果：我们招募了161名接受奥沙利铂为基础化疗的患者。他们的平均年龄为69岁，63.3%是男性。在研究期间，有9名（5.6％）患者出现了侧支血管。在以奥沙利铂为基础的化疗后，104例(64.6%)患者脾脏大小增加,19.4%的患者增加≥30%。单因素分析显示，纤维化-4（FIB-4）指数（≥1.76；OR9.17），天冬氨酸氨基转移酶：血小板比率指数（APRI）（≥0.193；OR9.62），奥沙利铂的累积剂量（≥1000mg；OR8.43），脾脏大小增加(≥30%;OR6.01)是侧支血管发育的显著危险因素。多因素分析显示，FIB-4指数和脾脏大小是显著的独立预测因素。
结论：基于奥沙利铂的化疗6个月后，FIB-4指数增加≥1.76和脾脏大小增加≥30%是侧支血管发育的重要预测指标。
