Bhaskara Achala, Eng Cathy
Department of Internal Medicine, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Clin Colorectal Cancer. 2008 Jan;7(1):65-8. doi: 10.3816/CCC.2008.n.010.
The development of brain metastases originating from colorectal cancer (CRC) is an infrequent phenomenon occurring in < 5% of patients. Yet, it is feasible that physicians will be diagnosing more patients with brain metastases because of the prolonged survival in our current patient population. The anti-angiogenic agent bevacizumab is currently approved in bevacizumab-naive patients with metastatic CRC (mCRC). Initially, precautionary measures regarding the use of bevacizumab were recommended for patients at risk of bleeding based on earlier incidents of intracranial hemorrhage, hemoptysis, and pulmonary hemorrhage. However, recent data support the use of bevacizumab in the treatment of high-grade gliomas. We present a challenging case of a treatment-naive patient with mCRC with brain metastases and the challenges involved in weighing the risks and benefits of systemic chemotherapy when combined with a biologic agent.
源自结直肠癌（CRC）的脑转移瘤的发生是一种罕见现象，发生率低于5%的患者。然而，由于我们当前患者群体生存期的延长，医生诊断出更多脑转移瘤患者是可行的。抗血管生成药物贝伐单抗目前已被批准用于初治的转移性结直肠癌（mCRC）患者。最初，基于早期发生的颅内出血、咯血和肺出血事件，建议对有出血风险的患者采取有关使用贝伐单抗的预防措施。然而，最近的数据支持贝伐单抗用于治疗高级别胶质瘤。我们报告了一例具有挑战性的病例，一名初治的mCRC伴脑转移瘤患者，以及在权衡全身化疗与生物制剂联合使用时的风险和益处所涉及的挑战。
