[Successful management with partial splenic embolization (PSE) of splenomegaly and thrombocytopenia caused by oxaliplatin-based chemotherapy for advanced colorectal cancer]

Gan To Kagaku Ryoho. 2011 May;38(5):835-9.
[Article in Japanese]

Abstract

We report here two cases of advanced colorectal cancer which received chemotherapy, in which partial splenic embolization (PSE) had been effective for controlling splenomegaly and thrombocytopenia. Case 1: A 50-year-old man presented with bloody urine and bloody stool. Computed tomography (CT) showed rectosigmoid cancer with urinary bladder invasion. He underwent colostomy and received chemotherapy. After 3 courses of FOLFOX and 6 courses of bevacizumab/FOLFOX, he suffered from thrombocytopenia with splenomegaly, which led to discontinuation of the therapy. PSE improved thrombocyte counts and enabled him to resume therapy. Case 2: A 72-year-old man presented with bloody stool. Endoscopy and CT showed an advanced rectosigmoid cancer with multiple liver metastases. He underwent low anterior resection and received chemotherapy with FOLFOX and FOLFIRI, together with bevacizumab. After 13 courses of chemotherapy, he also suffered from splenomegaly and thrombocytopenia. PSE produced an increase in thrombocyte count and allowed for a restart of chemotherapy. Oxaliplatin-based chemotherapy may possibly produce hepatic sinusoidal dilation and induce splenomegaly owing to portal hypertension. PSE seemed to be useful for treating thrombocytopenia with splenomagaly, and allowed continuation of the chemotherapy.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Embolization, Therapeutic
  • Humans
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Organoplatinum Compounds / adverse effects*
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin
  • Rectal Neoplasms / drug therapy*
  • Rectal Neoplasms / pathology
  • Sigmoid Neoplasms / drug therapy*
  • Sigmoid Neoplasms / pathology
  • Splenomegaly / chemically induced
  • Splenomegaly / therapy*
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / therapy*
  • Urinary Bladder Neoplasms / drug therapy
  • Urinary Bladder Neoplasms / secondary

Substances

  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Oxaliplatin