Hepatotoxicity of Chemotherapy
Paul D. King(a) and Michael C. Perry(b)
a Gastroenterology and Hepatology,
b Hematology and Medical Oncology, Department of Internal Medicine, University of Missouri-Columbia, Columbia, Missouri, USA
Correspondence: Michael C. Perry, M.D., Division of Hematology/Oncology, University of Missouri Ellis Fischel Cancer Center, 115 Business Loop 70 West, Columbia, Missouri 65203, USA. Telephone: 573-882-4979; Fax: 573-884-6050; e-mail: email@example.com
After assessment of tumor histology, the next important factor to consider in the selection of a chemotherapy regime is organ function. Patients who are to receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs may not be appropriate, and which drug doses should be modified.
Following therapy abnormalities of liver function tests may be due to the therapy rather than to progressive disease, and this distinction is of critical importance. Furthermore, not all abnormalities in liver function are due to the tumor or its treatment, and other processes, such as hepatitis, must be kept in mind.
This article reviews the hepatic toxicity of chemotherapeutic agents, and suggests dose modifications based upon liver function abnormalities. Emphasis is placed on agents known to be hepatotoxic, and those agents with hepatic metabolism.
Conclusions from the Full Text:
Chemotherapeutic agents, alone or in combination, may cause hypersensitivity reactions or direct hepatic toxicity, and altered liver function may alter drug metabolism and cause an increased risk of nonhepatic toxicity. Guidelines on dose modification in hepatic disease are largely empiric (Table 2). The dosing of doxorubicin is an example of such an empiric guideline, but the situation may be much more complex [81, 194]. Clinical judgment and a high index of suspicion remain critical tools in preventing and treating hepatic manifestations of cancer chemotherapy.
The Oncologist, Vol. 6, No. 2, 162-176, April 2001
196 references on a little-known
(especially to patients) problem
J Am Soc Nephrol 2010; 21.
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