Hiramoto Keiichiro, Kuroki Michio, Nakano Eriko, Kanno Nana, Matsumura Yoshifumi, Miura Atsushi, Kikuchi Yoshifumi, Hirakawa Hidetoshi
Dept. of Gastroenterology, Yamagata City Hospital Saiseikan.
Gan To Kagaku Ryoho. 2011 May;38(5):835-9.
We report here two cases of advanced colorectal cancer which received chemotherapy, in which partial splenic embolization (PSE) had been effective for controlling splenomegaly and thrombocytopenia. Case 1: A 50-year-old man presented with bloody urine and bloody stool. Computed tomography (CT) showed rectosigmoid cancer with urinary bladder invasion. He underwent colostomy and received chemotherapy. After 3 courses of FOLFOX and 6 courses of bevacizumab/FOLFOX, he suffered from thrombocytopenia with splenomegaly, which led to discontinuation of the therapy. PSE improved thrombocyte counts and enabled him to resume therapy. Case 2: A 72-year-old man presented with bloody stool. Endoscopy and CT showed an advanced rectosigmoid cancer with multiple liver metastases. He underwent low anterior resection and received chemotherapy with FOLFOX and FOLFIRI, together with bevacizumab. After 13 courses of chemotherapy, he also suffered from splenomegaly and thrombocytopenia. PSE produced an increase in thrombocyte count and allowed for a restart of chemotherapy. Oxaliplatin-based chemotherapy may possibly produce hepatic sinusoidal dilation and induce splenomegaly owing to portal hypertension. PSE seemed to be useful for treating thrombocytopenia with splenomagaly, and allowed continuation of the chemotherapy.
我们在此报告两例晚期结直肠癌患者接受化疗的情况，其中部分脾栓塞术（PSE）在控制脾肿大和血小板减少方面有效。病例1：一名50岁男性出现血尿和便血。计算机断层扫描（CT）显示乙状结肠直肠癌侵犯膀胱。他接受了结肠造口术并接受化疗。在接受3个疗程的FOLFOX方案和6个疗程的贝伐单抗/FOLFOX方案后，他出现了脾肿大伴血小板减少，导致治疗中断。PSE提高了血小板计数，使他能够恢复治疗。病例2：一名72岁男性出现便血。内镜检查和CT显示晚期乙状结肠直肠癌伴多发肝转移。他接受了低位前切除术，并接受了FOLFOX、FOLFIRI方案化疗以及贝伐单抗治疗。在接受13个疗程的化疗后，他也出现了脾肿大和血小板减少。PSE使血小板计数增加，并允许重新开始化疗。基于奥沙利铂的化疗可能会导致肝血窦扩张，并由于门静脉高压引起脾肿大。PSE似乎对治疗脾肿大伴血小板减少有用，并允许继续化疗。
