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International Journal of Hepatology
Volume 2013, Article ID 815105, 8 pages
http://dx.doi.org/10.1155/2013/815105
Review Article

Liver Injury Induced by Anticancer Chemotherapy and Radiation Therapy

1Department of Gastroenterology and Hepatology, Sheba Medical Center, 52621 Tel-Hashomer, Israel
2Department of Internal Medicine C, Kaplan Medical Center, The Hebrew University of Jerusalem, 76100 Rehovot, Israel

Received 5 November 2012; Accepted 3 May 2013

Academic Editor: Matthias Bahr

Copyright © 2013 Y. Maor and S. Malnick. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cytotoxic chemotherapy prolongs survival of patients with advanced and metastatic tumors. This is, however, a double-edged sword with many adverse effects. Since the liver has a rich blood supply and plays an active role in the metabolism of medications, it is not surprising that there can be hepatic injury related to chemotherapy. In addition, radioembolization may affect the parenchyma of normal and cirrhotic livers. We review chemotherapy-associated liver injury in patients with colorectal liver metastases, including downsizing chemotherapy and neoadjuvant chemotherapy. We discuss the mechanism of the hepatic injury, secondary to reactive oxygen species, and the spectrum of hepatic injury including, steatosis, steatohepatitis, hepatic sinusoidal injury and highlight the pharmacogenomics of such liver insults. Methods for reducing and treating the hepatotoxicity are discussed for specific agents including tamxifen and the newly introduced targeted antibodies.