Chen Hui, Wu Susan, Kundra Ajay, Aja Onu Iheanyichukwu, Gotlieb Vladimir, Wang Jen C
Division of Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA.
Department of Pathology, South Nassau Communities Hospital, Oceanside, NY, USA.
World J Oncol. 2015 Jun;6(3):383-386. doi: 10.14740/wjon924w. Epub 2015 Jun 12.
Perioperative chemoradiotherapy is considered to be one of the standards of care for early-stage gastric cancer, especially when it involves the esophagogastric junction or greater curvature. To date, there are no reported cases of gastrointestinal perforation in the literature, including many major clinical trials of adjuvant or neoadjuvant chemoradiotherapy for gastric cancer. It is important to recognize and manage this rare, but fatal complication in a timely manner. We report one case of gastrointestinal perforation in a gastric cancer patient undergoing neoadjuvant chemoradiotherapy with 5-fluorouracil and oxaliplatin. A 75-year-old man was diagnosed with stage IV gastric cancer (T4N1M0). We started neoadjuvant chemoradiotherapy with 5-fluorouracil and oxaliplatin. After he finished the first cycle, the patient presented to emergency room with severe abdominal pain of sudden onset. Computed tomography showed moderate pneumoperitoneum and perihepatic fluid. The patient expired 6 hours after he presented to emergency room.
围手术期放化疗被认为是早期胃癌的标准治疗方法之一，尤其是当病变累及食管胃交界部或胃大弯时。迄今为止，文献中尚无胃肠道穿孔的报道，包括许多关于胃癌辅助或新辅助放化疗的大型临床试验。及时识别和处理这种罕见但致命的并发症非常重要。我们报告1例接受5-氟尿嘧啶和奥沙利铂新辅助放化疗的胃癌患者发生胃肠道穿孔的病例。一名75岁男性被诊断为IV期胃癌（T4N1M0）。我们开始用5-氟尿嘧啶和奥沙利铂进行新辅助放化疗。在他完成第一个周期后，患者因突发严重腹痛就诊于急诊室。计算机断层扫描显示中度气腹和肝周积液。患者在就诊于急诊室6小时后死亡。
