Uchino Tairin, Mishima Hideyuki, Kimura Kengo, Mori Daiki, Ando Keiichi, Nagata Hiroshi, Kondo Riki, Kosaka Kenshi, Ohashi Norifumi, Ito Nobuhiro, Arikawa Takashi, Miyachi Masahiko, Suzumura Kazuyoshi, Sano Tsuyoshi, Nonami Toshiaki
Dept. of Gastroenterological Surgery, Aichi Medical University Hospital.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2506-8.
We report 4 cases of gastrointestinal perforation associated with systemic administration of bevacizumab. Case 1: A 51- year-old man with colorectal cancer (CRC) received mFOLFOX+bevacizumab (Bev). A small intestinal perforation occurred 7 days after Bev administration (Bev-a) and was successfully treated with omental packing. Case 2: A 50-year-old woman with CRC received capecitabine+Bev. A small intestinal perforation was detected 5 days after Bev-a, and was successfully treated with primary suture and an omental flap. Case 3: A 74-year-old man with CRC received CapeOX+Bev. A duodenal perforation occurred on the same day as Bev-a, but could be treated conservatively. Case 4: A 57-year-old man with lung cancer received DTX+Bev. A small intestinal perforation occurred 13 days after Bev-a, but this could be managed with primary suture and an omental flap. The gastrointestinal perforation presented with mild abdominal pain and was detected within 14 days after Bev-a in each of these 4 cases. Three patients were successfully treated with only minimal surgical procedures and 1 patient could be managed with conservative treatment for a perforated duodenal ulcer.
我们报告了4例与贝伐单抗全身给药相关的胃肠道穿孔病例。病例1：一名51岁的结肠直肠癌（CRC）男性接受了mFOLFOX方案联合贝伐单抗（Bev）治疗。在给予贝伐单抗（Bev-a）7天后发生小肠穿孔，经网膜填塞成功治疗。病例2：一名50岁的CRC女性接受了卡培他滨联合贝伐单抗治疗。在Bev-a后5天检测到小肠穿孔，经一期缝合和网膜瓣成功治疗。病例3：一名74岁的CRC男性接受了CapeOX方案联合贝伐单抗治疗。在Bev-a当天发生十二指肠穿孔，但可保守治疗。病例4：一名57岁的肺癌男性接受了多西他赛联合贝伐单抗治疗。在Bev-a后13天发生小肠穿孔，但可通过一期缝合和网膜瓣处理。这4例患者的胃肠道穿孔均表现为轻度腹痛，且在Bev-a后14天内被发现。3例患者仅通过最小限度的外科手术成功治疗，1例患者因十二指肠溃疡穿孔接受保守治疗。
