Chemotherapy is one of the fundamental treatments in cancer patients, which has significantly improved survival rate. Alongside positive effects, many side effects. One of major side effects of these drugs is hepatotoxicity, initially develops as fatty liver and hepatic steatosis, but progresses to liver failure if harmful factor persist. To determine prevalence of fatty liver in breast and gastrointestinal cancers during and after chemotherapy and to investigate some of its effective causes.
This longitudinal cohort study was performed breast or gastrointestinal cancer patients undergoing chemotherapy at the Oncology Clinic of Birjand University of Medical Sciences, 2016-2017. Before and after chemotherapy, the patients were evaluated by sonography for fatty liver. Data were imported into SPSS software version 19 and analyzed by Chi-Square (or Fisher Test) and McNemar at 5% significance level.
A total of 152 patients were enrolled in the study, of whom 85 had breast cancer and 67 had gastrointestinal cancers. Most patients were in age group of 45-54 years old (48 cases, 31.6%). Mean body mass index (BMI) was 23.17 ± 4.52. Frequency of fatty liver before and after chemotherapy increased from 2% to 46.7% in all patients (p = 0.0001). Frequency of fatty liver after chemotherapy was significantly higher in females than males (34.7 and 52.4%, respectively, p=0.04). There was no significant relationship between chemotherapy induced fatty liver with age (p=0.9), BMI (p=0.17), history of diabetes mellitus (p=0.2), and metabolic syndrome presence (p=0.4). The highest frequency of fatty liver was observed in patients treated with AC-T, FOLFOX and ECF with 53.5%, 42.9% and 29.2%, respectively (p = 0.09).
Results showed that chemotherapy is associated with a significantly increased risk of fatty liver occurrence, which is higher in women than men. However, occurrence of fatty liver following chemotherapy, regardless of diabetes, metabolic syndrome or BMI, as well as age of the patients, can be expected in all scenarios.
Dr. Payam Izadpanahi from Reza Radiotherapy Oncology Center (RROC).
Birjand University of Medical Sciences.
All authors have declared no conflicts of interest.