Gupta Bhavna, LeVea Charles, Litwin Alan, Fakih Marwan G
Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Clin Colorectal Cancer. 2007 Mar;6(6):447-9. doi: 10.3816/CCC.2007.n.015.
Irinotecan-induced gastrointestinal toxicities are common and typically present in the form of diarrhea or nausea and vomiting. However, severe hyperbilirubinemia (grade 3/4) has not been previously reported in association with this chemotherapeutic agent. We report a case of prolonged grade 4 hyperbilirubinemia after a single dose of irinotecan at 125 mg/m(2). This severe toxicity was attributed to a UGT1A1 7/7 genotype and resolved to grade 2 after 8 weeks of supportive care. This case outlines the possibility of severe hepatic toxicity with moderate doses of irinotecan in patients with a UGT1A1 7/7 genotype. Despite the severity and prolonged duration of the associated irinotecan-induced hepatic toxicity, the management of similar cases should focus on intensive supportive measures because the toxicity is likely to resolve eventually.
伊立替康引起的胃肠道毒性很常见，通常表现为腹泻或恶心呕吐。然而，此前尚未有与这种化疗药物相关的严重高胆红素血症（3/4级）的报道。我们报告了一例在单剂量125 mg/m²伊立替康治疗后出现持续4级高胆红素血症的病例。这种严重毒性归因于UGT1A1 7/7基因型，在支持治疗8周后降至2级。该病例概述了UGT1A1 7/7基因型患者使用中等剂量伊立替康时发生严重肝毒性的可能性。尽管伊立替康引起的相关肝毒性严重且持续时间长，但对类似病例的管理应侧重于强化支持措施，因为毒性最终可能会消退。
