THE IMPACT OF COMPREHENSIVE TREATMENT ON THE PROGRESSION OF LIVER FIBROSIS IN PATIENTS AFTER POLYCHEMOTHERAPY
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i2.13902Keywords:
drug-induced liver injury, polychemotherapy, fibrosisAbstract
SUMMARY. The toxic effects of medications on the body, particularly the liver, are often observed during the administration of antineoplastic agents. Despite this, there is currently no standardized treatment strategy for such drug-induced liver injuries, which are among the most serious complications of chemotherapy [1, 3, 4, 7]. This article examines the impact of comprehensive treatment on the progression of liver fibrosis in patients after polychemotherapy.
The aim – to investigate and explore the possibility of comprehensive treatment for post-hepatitis liver fibrosis as a medication-induced condition resulting from cytostatic therapy for breast cancer, in combination with overweight and obesity.
Material and Methods. The study involved women aged 35 to 79 years with liver fibrosis classified as F1-F2 and varying body mass index (normal weight, overweight, and grade 1 obesity), who were divided into two groups. Patients in Group I received non-medication therapy, while patients in Group II received medication therapy in the form of ursodeoxycholic acid and vitamin E. After completing the treatment, patients underwent a comprehensive set of clinical, laboratory, and instrumental examinations to compare the effects of the prescribed therapy.
Results. Administration of ursodeoxycholic acid at a dose of 15 mg/kg per day and vitamin E at a dose of 400 IU per day led to a reduction in clinical manifestations of the disease and stiffness indicators of liver parenchyma based on shear wave elastography (by 17.9 %). It also resulted in the normalization of indirect markers of liver fibrosis such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and prothrombin time, as well as gradual normalization of direct markers COL-4 and TGF-β1 according to dynamic observation. The proposed treatment approach in a significant portion of patients not only reduced liver echogenicity but also slowed down the rate of liver fibrosis progression.
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