Kuwabara Hiroshi, Baba Hironobu, Wakabayashi Mai, Nakamura Hiroshi, Sanada Takahiro, Baba Hiroyuki, Nakajima Kazumi, Goseki Narihide
Dept. of Surgery, Shuwa General Hospital.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2250-2.
A 58-year-old woman, who was undergoing peritoneal dialysis( PD) for chronic kidney disease (CKD) and had been operated by sigmoidectomy for early colonic cancer, was diagnosed as peritoneal recurrence of the colonic cancer. Her treatment for CKD was switched from PD to hemodialysis. She was administered mFOLFOX6 therapy(reducing the dose to 70%). Hemodialysis was performed 1 hour after administration of oxaliplatin on day 1 and repeated two days later after the completion of drug administration. No serious adverse events were observed. After 10 courses of mFOLFOX6, an ovarian metastasis was appeared. We then changed the regimen to FOLFIRI (70% dose)/bevacizumab (BV). Neutropenia (grade 4) was observed after the second treatment. After some rest, 21 courses of FOLFIRI/BV therapy were performed safely by reducing the dose to 60%. We thought that a reduced dose of FOLFIRI/BV therapy appeared to be safe for a patient with chronic kidney disease who is on hemodialysis.
一名58岁女性,因慢性肾脏病接受腹膜透析治疗,曾因早期结肠癌接受乙状结肠切除术,被诊断为结肠癌腹膜复发。她的慢性肾脏病治疗从腹膜透析改为血液透析。给予她mFOLFOX6治疗(剂量减至70%)。在第1天给予奥沙利铂后1小时进行血液透析,并在药物给药完成两天后重复进行。未观察到严重不良事件。mFOLFOX6治疗10个疗程后,出现卵巢转移。然后我们将治疗方案改为FOLFIRI(70%剂量)/贝伐单抗(BV)。第二次治疗后观察到4级中性粒细胞减少。经过一段时间休息后,通过将剂量减至60%,安全地进行了21个疗程的FOLFIRI/BV治疗。我们认为,降低剂量的FOLFIRI/BV治疗对于接受血液透析的慢性肾脏病患者似乎是安全的。