Nagata Yasunobu, Omuro Yasushi, Shimoyama Tatsu, Sasaki Eisaku, Okamoto Rumiko, Maeda Yoshiharu, Kishida Shuji, Sasaki Tsuneo
Dept. of Chemotherapy, Tokyo Metropolitan Cancer and Infectious Disease Center-Komagome Hospital.
Gan To Kagaku Ryoho. 2009 Jul;36(7):1163-6.
We report a rare case of reversible posterior leukoencephalopathy syndrome (RPLS) induced by 5-FU and oxaliplatin (FOLFOX regime). A 35-year-old woman with ileus was diagnosed with sigmoid cancer Stage IV (T4N4M0P2H0), and excision of the sigmoid colon, and left ureteroureteral anastomosis was performed. Postoperative chemotherapy with FOLFOX4 was performed. Complications of hypertension were seen on day 6, and convulsions on day 11 after chemotherapy. Headache and visual disturbance were also complications. MRI of the brain revealed bilateral high signal intensities of posterior lobes on T2 weighted and FLAIR images without enhancement. The patient was treated with antihypertensive therapy and anticonvulsive therapy. Her symptoms entirely disappeared, including the bilateral posterior lesions on MRI after two weeks. This report would suggest that medical oncologists should be aware that multidrug chemotherapies may increase the risk of fatal neurological complications like RPLS.
我们报告了一例由5-氟尿嘧啶和奥沙利铂（FOLFOX方案）诱发的可逆性后部白质脑病综合征（RPLS）的罕见病例。一名35岁患有肠梗阻的女性被诊断为乙状结肠癌IV期（T4N4M0P2H0），并接受了乙状结肠切除术和左输尿管输尿管吻合术。术后进行了FOLFOX4化疗。化疗后第6天出现高血压并发症，第11天出现惊厥。头痛和视觉障碍也是并发症。脑部MRI显示，在T2加权和液体衰减反转恢复（FLAIR）图像上双侧后叶呈高信号强度，无强化。患者接受了抗高血压治疗和抗惊厥治疗。两周后，她的症状完全消失，包括MRI上的双侧后部病变。本报告提示，肿瘤内科医生应意识到多药化疗可能增加发生如RPLS等致命性神经并发症的风险。
