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Ivanikov I.O.

Pirogov Russian National Research Medical University of the Russian Ministry of Health;
Central Clinical Hospital of Russian Federation Presidential Administration

Vinogradova N.N.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Krashenkov O.P.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Kotselapova E.Yu.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Grigorieva Yu.V.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation;
Pirogov Russian National Research Medical University

Myasnikova E.V.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Pikunova I.N.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Treatment of the chemotherapy induced hepatotoxicity

Authors:

Ivanikov I.O., Vinogradova N.N., Krashenkov O.P., Kotselapova E.Yu., Grigorieva Yu.V., Myasnikova E.V., Pikunova I.N.

More about the authors

Journal: Russian Journal of Evidence-Based Gastroenterology. 2020;9(4): 7‑15

DOI: 10.17116/dokgastro202090417

Views: 19964

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To cite this article:

Ivanikov IO, Vinogradova NN, Krashenkov OP, Kotselapova EYu, Grigorieva YuV, Myasnikova EV, Pikunova IN. Treatment of the chemotherapy induced hepatotoxicity. Russian Journal of Evidence-Based Gastroenterology. 2020;9(4):7‑15. (In Russ.)
https://doi.org/10.17116/dokgastro202090417

Подписка 2025 (Russian Journal of Evidence-Based Gastroenterology)
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Treatment of chemotherapy-induced hepatotoxicity (CIH) is a pressing challenge for oncology and gastroenterology.

AIM

To study the efficacy of several hepatoprotectors in CIH.

MATERIAL AND METHODS

144 patients with a tumor of one of the three localizations (breast cancer, colorectal cancer, and prostate cancer) received 912 courses of chemotherapy. Chemotherapy was suspended in patients if the AST and ALT were 5 times the ULN, and the bilirubin level was three times the ULN. For CIS treatment, hepatoprotectors S-adenosylmethionine or essential phospholipids with glycyrrhizic acid, sterofundin solution, and ursodeoxycholic acid were used for at least four weeks.

RESULTS

50 (35%) patients had an elevation in the liver function tests ranged from 2 to 20 times ULN. Thirty-six patients had moderate (grade 2) and four patients severe (grade 3) hepatotoxicity. We used S-adenomethionine in 39 patients and essential phospholipids in combination with glycyrrhizic acid in 11 patients. Ursodeoxycholic acid was added in the presence of cholestatic syndrome in 22 patients. Sterofundin infusion, in combination with hepatoprotectors for ten days and subsequent oral administration of the latter, led to a significant decrease in liver function tests in all patients in 7-30 days.

CONCLUSION

The treatment regimens we used have shown their effectiveness in treating CIH in cancer patients with moderate and severe hepatotoxicity.

Keywords:

chemotherapy
liver
hepatoprotectors
hepatotoxicity

Authors:

Ivanikov I.O.

Pirogov Russian National Research Medical University of the Russian Ministry of Health;
Central Clinical Hospital of Russian Federation Presidential Administration

Vinogradova N.N.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Krashenkov O.P.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Kotselapova E.Yu.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Grigorieva Yu.V.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation;
Pirogov Russian National Research Medical University

Myasnikova E.V.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Pikunova I.N.

Central Clinical Hospital with Polyclinic of Administrative Directorate of the President of the Russian Federation

Received:

02.10.2020

Accepted:

05.11.2020

List of references:

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  2. Kaprin AD, Starinsky VV, Petrova GV. Zlokachestvennye novoobrazovaniya v Rossii v 2017 godu (zabolevaemost’ i smertnost’). M.: MNIOI im. P.A. Gertsena — filial FGBU «NMITs radiologii» Minzdrava Rossii; 2018. (In Russ.).
  3. Alyeva AA, Nikitin IG, Arkhipov AV. Accompanying therapy of acute drug-induced liver damage during chemotherapy treatment in patients with breast cancer. Lechebnoe delo. 2018;2:78-84. (In Russ.).
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  6. Syutkin VE, Ivanikov IO. Possibilities of antibacterial therapy in chronic liver diseases and hepatotoxicity of antibacterial drugs. Kremlevskaya meditsina. Klinicheskij vestnik. 2005;1:35-38. (In Russ.).
  7. Grigorian A, O’Brien CB. Hepatotoxicity Secondary to Chemotherapy. Journal of Clinical and Translational Hepatology. 2014;2(2):95-102.  https://doi.org/10.14218/JCTH.2014.00011
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