Ann Surg Treat Res.  2018 Sep;95(3):161-167. 10.4174/astr.2018.95.3.161.

Protective effect of Korean red ginseng on oxaliplatin-mediated splenomegaly in colon cancer

• Kang J
• Park JS
• Ahn SG
• Lim JH
• Baik SH
• Yoon DS
• Lee KY
• Jeong J

• KMID: 2419447
• DOI: http://doi.org/10.4174/astr.2018.95.3.161

Abstract

PURPOSE
This study investigated how adding Korean red ginseng extract (KRG) to folinic acid, fluorouracil and oxaliplatin (FOLFOX) chemotherapy affected the rate of splenomegaly in colon cancer.
METHODS
This retrospective study analyzed 42 patients who were randomly assigned to receive a FOLFOX regimen with or without KRG. Spleen volume change was assessed by computed tomography scans measured before surgery (presurgery volume) and 3 weeks after cessation of the 12th cycle of FOLFOX (postchemotherapy volume).
RESULTS
All patients showed increased spleen volume. No difference was observed in median presurgery and postchemotherapy volume between the KRG and control groups. However, a ratio defined as postchemotherapy volume divided by presurgery volume was significantly lower in the KRG group than the control group (median, 1.38 [range, 1.0-2.8] in KRG group vs. median, 1.89 [range, 1.1-3.0] in control group, P = 0.028). When splenomegaly was defined as a >61% increase in spleen volume, the rate of splenomegaly was significantly lower in the KRG group than the control group (28.6% vs. 61.9%, P = 0.03). KRG consumption was inversely associated with developing splenomegaly in multivariate analysis.
CONCLUSION
Adding KRG during FOLFOX chemotherapy for colon cancer might protect against oxaliplatin-induced splenomegaly. The protective effect of Korean red ginseng should be investigated with further research.

Keyword

Oxaliplatin; Splenomegaly; Colonic neoplasms; Folfox protocol

MeSH Terms

Colon*
Colonic Neoplasms*
Drug Therapy
Fluorouracil
Humans
Leucovorin
Multivariate Analysis
Panax*
Retrospective Studies
Spleen
Splenomegaly*
Fluorouracil
Leucovorin

Figure

• 

  Fig. 1 CT based voulmetry. Spleen volume was measured by manual calculation for CT slices and summation of boundaries was determined by a 3-dimensional program.

• 

  Fig. 2 Receiver operating characteristic (ROC) curve. ROC curve revealed that the most accurate cutoff value predicting occurrence of thrombocytopenia after cessation of chemotherapy was Youden's index 1.612 (area under the curve, 0.687; sensitivity, 70.6%; specificity, 28%).

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