Multidimensional clinical assessment and outcome analysis of oxaliplatin-induced hepatic sinusoidal obstruction syndrome
- VernacularTitle:奥沙利铂所致肝窦阻塞综合征的多维度临床评估与转归分析
- Author:
Huadong HONG
1
;
Jian’an BAO
1
;
Jingjing MA
1
Author Information
1. Dept. of Pharmacy，Soochow University Medical Center/The Fourth Affiliated Hospital of Soochow University/Suzhou Dushu Lake Hospital，Jiangsu Suzhou 215000，China
- Publication Type:Journal Article
- Keywords:
Oxaliplatin;
hepatic sinusoidal obstruction syndrome;
hepatic sinusoidal dilatation;
Adverse drug reaction;
drug-induced disease
- From:
China Pharmacy
2026;37(19):2560-2565
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To improve the clinical recognition and management of oxaliplatin-induced hepatic sinusoidal obstruction syndrome （HSOS）.METHODS A systematic search was conducted in PubMed， Web of Science， Embase， CNKI， VIP， and Wanfang Medical Database to collect cases of oxaliplatin-induced HSOS. Typical cases admitted to the Fourth Affiliated Hospital of Soochow University （hereinafter referred to as “our hospital”） were also included. The clinical characteristics， laboratory findings， imaging manifestations， treatment， and prognosis of oxaliplatin-induced HSOS were systematically analyzed， and subgroup analyses were performed according to chemotherapy regimen and patient sex.RESULTS A total of 32 cases of oxaliplatin-induced HSOS were collected （31 from the literature and 1 from our hospital）. Among them， there were 16 males and 16 females， with a median age of 58.5 years and a median time to onset of 168 days. The most common laboratory abnormality was elevated alkaline phosphatase （ALP）/ γ -glutamyl transferase （GGT） （accounting for 69.2% of reported cases， 9/13）， and some patients had elevated transaminases and thrombocytopenia. Imaging findings included splenomegaly （37.5%， 12/32）， intrahepatic hypodense lesions （28.1%， 9/32）， signs of portal hypertension （21.9%， 7/32）， etc. Treatment mainly consisted of discontinuation of oxaliplatin， supplemented with symptomatic supportive treatment or liver resection. The overall improvement rate of patients was 84.0% （21/25）. Subgroup analysis showed that among patients receiving the FOLFOX regimen， 36.8% developed symptoms within 168 days， which was significantly lower than the proportion of patients receiving other regimens （83.3%） （ P ＜0.012 5）.CONCLUSIONS Oxaliplatin-induced HSOS often presents with elevated ALP/GGT and splenomegaly. Hypodense lesions on imaging are a key point in differential diagnosis. Most patients improve after discontinuation of oxaliplatin and symptomatic supportive treatment. Clinically， emphasis should be placed on early recognition of this complication and close monitoring of liver function and imaging changes.
