Saif Muhammad Wasif
Tufts University School of Medicine, 800 Washington Street, Suite 7S-7099, Boston, MA 02111, USA.
Case Rep Oncol Med. 2014;2014:790192. doi: 10.1155/2014/790192. Epub 2014 Mar 12.
Liver metastases are commonly encountered in patients presenting with metastatic colorectal cancer (mCRC); resection is the treatment of choice. A number of systemic treatment options are currently available for such patients, including the use of 5-fluorouracil-based chemotherapies and oxaliplatin (e.g., FOLFOX) in combination with biologic agents that target angiogenesis (e.g., bevacizumab). For patients with progression following first-line treatment, current second-line options include a change in chemotherapy with bevacizumab (for patients who did or did not receive prior bevacizumab) or FOLFIRI in combination with aflibercept, a more recently approved antiangiogenesis therapy. Neurotoxicity is a well-established adverse event of oxaliplatin-based therapy. The current case details an mCRC patient with liver metastases who was treated with a capecitabine and oxaliplatin regimen (XELOX), and experienced two episodes of transient cortical blindness possibly related to oxaliplatin. After disease progression, the patient was switched to a regimen of FOLFIRI and aflibercept and did well on this second-line regimen.
肝转移在转移性结直肠癌（mCRC）患者中很常见；手术切除是首选治疗方法。目前有多种全身治疗方案可供此类患者选择，包括使用基于5-氟尿嘧啶的化疗药物和奥沙利铂（如FOLFOX）联合靶向血管生成的生物制剂（如贝伐单抗）。对于一线治疗后病情进展的患者，目前的二线治疗方案包括更换化疗方案（对于之前接受或未接受过贝伐单抗治疗的患者），或FOLFIRI联合阿柏西普（一种最近获批的抗血管生成疗法）。神经毒性是基于奥沙利铂治疗的一种公认的不良事件。本病例详细介绍了一名患有肝转移的mCRC患者，该患者接受了卡培他滨和奥沙利铂方案（XELOX）治疗，并经历了两次可能与奥沙利铂相关的短暂性皮质盲发作。疾病进展后，患者改用FOLFIRI和阿柏西普方案，二线治疗方案效果良好。
