Miyamoto Shingo
Department of Oncology, Japanese Red Cross Medical Center.
Nihon Shokakibyo Gakkai Zasshi. 2014 Apr;111(4):743-7.
We report a rare case of a 67-year-old woman with metastatic colorectal cancer whose bevacizumab (B-mab) +m-FOLFOX6 treatment was complicated by reversible posterior leukoencephalopathy syndrome (RPLS). In July 2011, she underwent a right hemicolectomy for cecal carcinoma with peritoneal dissemination; therefore, m-FOLFOX6 was started in September 2011. In November 2011, she was hospitalized to add B-mab to the existing regimen. Subsequently, she developed hypertension on day 4 after the first B-mab infusion, followed by headache, convulsions, and disturbance of consciousness on day 5. T2-weighted and fluid-attenuated inversion recovery (FLAIR) non-enhanced magnetic resonance imaging of the brain revealed bilateral high signal intensities in the posterior lobes. She was diagnosed with RPLS and referred to our department where she was treated with antihypertensives and anticonvulsives. Her symptoms entirely resolved over 12 days. Medical oncologists should be aware that multidrug chemotherapies with B-mab may increase the risk of fatal neurological complications such as RPLS.
我们报告了一例罕见的67岁转移性结直肠癌女性病例，其接受贝伐单抗（B-mab）+m-FOLFOX6治疗后出现可逆性后部白质脑病综合征（RPLS）。2011年7月，她因盲肠癌伴腹膜播散接受了右半结肠切除术；因此，m-FOLFOX6于2011年9月开始使用。2011年11月，她因在现有治疗方案中添加B-mab而住院。随后，在首次输注B-mab后的第4天出现高血压，第5天出现头痛、抽搐和意识障碍。脑部T2加权和液体衰减反转恢复（FLAIR）非增强磁共振成像显示双侧后叶高信号强度。她被诊断为RPLS并转诊至我们科室，在那里接受了抗高血压药和抗惊厥药治疗。她的症状在12天内完全缓解。肿瘤内科医生应意识到，使用B-mab的多药化疗可能会增加发生如RPLS等致命神经并发症的风险。
