Godinho João, Casa-Nova Mafalda, Mesquita Teresa, Baptista Maria João, Araújo Francisco, Vale José, Passos Coelho José Luís
1 Oncology Department, Hospital Beatriz Ângelo, Loures, Portugal.
2 Internal Medicine Department, Hospital Beatriz Ângelo, Loures, Portugal.
J Oncol Pharm Pract. 2019 Mar;25(2):497-501. doi: 10.1177/1078155217739686. Epub 2017 Nov 9.
Capecitabine is a fluoropyrimidine commonly used in the treatment of colorectal cancer which may cause central nervous system toxicity, namely cerebellar dysfunction.
We describe a 77-year-old man undergoing adjuvant treatment of colon cancer with capecitabine and oxaliplatin who presented with acute cerebellar ataxia and encephalopathy that progressed to coma. Diagnosis of toxic encephalopathy was made after the exclusion of alternative causes of neurological dysfunction and complete resolution of clinical findings with permanent discontinuation of chemotherapy.
When patients with cancer develop symptoms and signs of central nervous dysfunction, metabolic and infectious causes plus tumor involvement of central nervous system must be sought. However, chemotherapy may also cause toxicity to the central nervous system. Capecitabine is no exception, although cerebellar dysfunction is rarely reported.
Although rare, capecitabine-induced encephalopathy may be severe and physicians should be aware of this possible side effect.
卡培他滨是一种常用于治疗结直肠癌的氟嘧啶，它可能会导致中枢神经系统毒性，即小脑功能障碍。
我们描述了一名77岁男性，正在接受卡培他滨和奥沙利铂辅助治疗结肠癌，他出现了急性小脑共济失调和脑病，并进展为昏迷。在排除神经功能障碍的其他原因且永久停用化疗后临床症状完全缓解，从而诊断为中毒性脑病。
当癌症患者出现中枢神经功能障碍的症状和体征时，必须寻找代谢和感染原因以及中枢神经系统的肿瘤累及情况。然而，化疗也可能导致中枢神经系统毒性。卡培他滨也不例外，尽管小脑功能障碍的报道很少。
尽管罕见，但卡培他滨引起的脑病可能很严重，医生应意识到这种可能的副作用。
