title: [Successful management with partial splenic embolization (PSE) of splenomegaly and thrombocytopenia caused by oxaliplatin-based chemotherapy for advanced colorectal cancer].
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.
authors.affiliation: Dept. of Gastroenterology, Yamagata City Hospital Saiseikan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Hiramoto
authors.forename: Michio
authors.initials: M
authors.lastname: Kuroki
authors.forename: Eriko
authors.initials: E
authors.lastname: Nakano
authors.forename: Nana
authors.initials: N
authors.lastname: Kanno
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miura
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Hirakawa
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004621:Embolization, Therapeutic; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009944:Organoplatinum Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D000077150:Oxaliplatin; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012811:Sigmoid Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013163:Splenomegaly / Q000139:chemically induced / Q000628:therapy*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000628:therapy*; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000556:secondary
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin