Analysis of Clinical Features and Imaging Manifestations of Drug-Induced Liver Injury after Treatment of Colorectal Cancer

In addition to surgical resection, chemotherapy is needed for patients with liver metastasis of colorectal cancer. Our aim was to investigate the computed tomography manifestations of liver injury after different chemotherapy regimens. These studies retrospectively analyzed patients with liver metastasis from colorectal cancer diagnosed in our hospital between April 2015 and April 2020. The sex, age, chemotherapy regimen (FOLFOX, FOLFOXIRI, cetuximab+FOLFOXIRI, bevacizumab+FOLFOXIRI, bevacizumab+FOLFOX) and liver computerized tomography imaging findings were reviewed. The results were expressed as the frequency and percentage for classified variables or the average and standard deviation for continuous variables ( age). The statistical significance was evaluated by crosstable chi- square analysis to determine the differences between groups of categorical variables. There were 170 patients with liver injury after chemotherapy, including 124 males and 46 females. The male- to-female ratio was 2.7 to 1. The imaging findings of the 170 patients were divided into diffuse, focal and small multifocal. The different chemotherapy regimens showed that 77 of the 87 cases of FOLFOX showed diffuse liver injury. Among the 45 cases of the FOLFOXIRI regimen, 43 cases showed focal liver injury. A total of 38 cases were treated with three regimens of cetuximab+FOLFOXIRI, bevacizumab+FOLFOXIRI, and bevacizumab+FOLFOX. Of these, 36 cases showed small multifocal liver injury. The chi-square test results showed that the chi-square value was 260.472 (p<0.000). The imaging changes of liver computed tomography have a certain sensitivity and specificity for liver injury after chemotherapy. Different types of liver injury after chemotherapy can be reflected by computed tomography imaging changes.