Oxaliplatin induced hepatic sinusoidal obstruction syndrome: prevention and treatment

Oxaliplatin is the third generation of platinum drugs, used in chemotherapy of colorectal carcinoma. Oxaliplatin can injure hepatic sinusoidal endothelial cells to induce hepatic sinusoidal obstruction syndrome (HSOS). The incidence of oxaliplatin induced HSOS was 77.4%. The clinical manifestations were hepatalgia, weight gain, ascites, hepatomegaly and jaundice. Histopathologic features include hepatic sinusoidal dilation and congestion, centrilobular vein obstruction, perisinusoidal fibrosis and centrilobular hepatic cell necrosis. The lack of typical imaging manifestations, biomarkers and effective treatment, so prevention-oriented strategy is important. Bevacizumab, regorafenib, sorafenib, recombinant human soluble thrombomodulin, and antioxidant may prevent HSOS. Defibrotide is recommended for treatment of HSOS. Key words: Oxaliplatin; Hepatic veno-occlusive disease; Diagnosis