Summary
Two female breast cancer patients who received combined tamoxifen and tegafur as postsurgical adjuvant therapy developed severe hepatotoxicity after being treated for three and eight months, respectively. Shortly after the cessation of the treatment, routine liver tests showed gradual recovery, but liver biopsies revealed chronic active hepatitis in one patient and liver cirrhosis in the other. Four and five years, respectively, after the cessation of the treatment, the results of liver tests were normal and distinct histological improvement was observed in both patients. Because these patients had no viral and immunoserological markers nor any history of alcohol abuse, this study suggested that the tamoxifen and tegafur regimen induced reversible chronic active liver disease.
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References
Ward HWC: Anti-estrogen therapy for breast cancer: A trial of tamoxifen at two dose levels. Br Med J 1:13–14, 1973
Nayfield SG, Karp JF, Ford LG, Dorr FA, Kramer BS: Potential role of tamoxifen in prevention of breast cancer J Natl Cancer Inst 83:1450–1459, 1991
Fugh-Berman A, Epstein S: Tamoxifen: Disease prevention or disease substitution? Lancet 340:1143–1145, 1992
Raloff J: Tamoxifen quandary. Sci News 141:266–269, 1992
Noguchi M, Taniya T, Tajiri K, Miwa I, Miyazaki H, Koshino H, Mabuchi H, Nomura A: Fatal hyperlipidemia in case of metastatic breast cancer treated by tamoxifen. Br J Surg 74:586–587, 1987
Patterson JS, Baum M: Safety of tamoxifen. Lancet 1:105, 1978
Kahn D, Eagon PK, Porter LE, Elm MS, Makowka BAL, Podesta L, Starzl TE, Thiel DHV: Effects of tamoxifen on hepatic regeneration in male rats. Dig Dis Sci 34:27–32, 1989
Loomus GN, Aneja P, Bota RA: A case of peliosis hepatis in association with tamoxifen therapy. Am J Clin Pathol 80:881–883, 1983
Blackburn AM, Amiel SA, Millis RR, Rubeens RD: Tamoxifen and liver damage. Br Med J 289:288, 1984
Majima H, Nishimura A: Toxic effects of prolonged oral administration of tegafur (FT-207). Jpn J Cancer Chemother 9:726–732, 1981
Fisher B, Gunduz N, Saffer EA, Zheng S: Relation of estrogen and its receptor to rat liver growth and regeneration. Cancer Res 44:2410–2415, 1984
Riippa P, Kauppila A, Sundstrom H, Vihko R: Hepatic impairment during simultaneous administration of medroxyprogesterone acetate and tamoxifen in the treatment of endometrial and ovarian carcinoma. Anticancer Res 4:109–112, 1984
Au JI, Sadee W: Activation of futorafur [R,S-1-(tetrahydro-2 furanyl)-5-fluorouracil] to 5-fluorouracil and γ-butyrolactone. Cancer Res 40:2814, 1980
Baba M, Shima T, Tanaka T, Nakamura M, Hasegawa H, Suzuki S, Kusano I: A case of allergic liver injury induced by tegafur. J Gastroenterol 29:88–92, 1994
Palmeri S, Gebbia V, Russo A: Oral tegafur in the treatment of gastrointestinal tract cancers: A phase II study. Br J Cancer 61:475–478, 1990
Willis CM, John KB: Progress in hepatology: Drug-induced chronic liver disease. J Gastroenterol 72:1348–1353, 1977
Hyman JZ: Drug-induced chronic hepatic disease. Med Clin North Am 63:567–582, 1979
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Maruyama, S., Hirayama, C., Abe, J. et al. Chronic active hepatitis and liver cirrhosis in association with combined tamoxifen/tegafur adjuvant therapy. Digest Dis Sci 40, 2602–2607 (1995). https://doi.org/10.1007/BF02220448
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DOI: https://doi.org/10.1007/BF02220448