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肾移植后结肠癌患者的化疗：一例病例报告并文献复习

Chemotherapy in patient with colon cancer after renal transplantation: A case report with literature review.

作者信息

Fang Wentong

机构信息

Department of Pharmacy, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Medicine (Baltimore). 2018 Feb;97(5):e9678. doi: 10.1097/MD.0000000000009678.

DOI:10.1097/MD.0000000000009678
PMID:29384845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5805417/
Abstract

RATIONALE

Experience of pharmacotherapy in posttransplantation colorectal cancer (CRC) patients is inadequate.

PATIENT CONCERNS

A Chinese man had right renal transplantation and began immunosuppressive treatment at the age of 31 in 2009. He was diagnosed with colon cancer and underwent anterior resection in 2014. He was diagnosed with metastatic colon carcinoma by abdomen computed tomography (CT) and positron emission tomography-computed tomography in April 2017.

DIAGNOSIS

Metastatic colon carcinoma in posttransplantation patient.

INTERVENTIONS

Three cycles of FLOFOX (5-fluorouracil and leucovorin and oxaliplatin) chemotherapy were given since April 2017.

OUTCOMES

Plasma concentrations of immunosuppressant and kidney function were within normal during the chemotherapy. Abdomen CT revealed the progress of colon cancer at the end of the third course of chemotherapy.

LESSONS

A few cases about monochemotherapy of posttransplantation CRC have been reported, whereas experience of doublet chemotherapy was currently unavailable. We shared the experience of FOLFOX in a patient with posttransplantation colon cancer. Neither of incompatibility with immunosuppressant nor serious adverse drug reaction was observed. It provides evidence for the pharmacotherapy of posttransplantation CRC.

摘要

原理

移植后结直肠癌（CRC）患者的药物治疗经验不足。

患者情况

一名中国男性于2009年31岁时接受了右肾移植并开始免疫抑制治疗。他于2014年被诊断为结肠癌并接受了前切除术。2017年4月，通过腹部计算机断层扫描（CT）和正电子发射断层扫描-计算机断层扫描诊断为转移性结肠癌。

诊断

移植后患者转移性结肠癌。

干预措施

自2017年4月起给予三个周期的FLOFOX（5-氟尿嘧啶、亚叶酸钙和奥沙利铂）化疗。

结果

化疗期间免疫抑制剂的血浆浓度和肾功能均正常。腹部CT显示在第三个化疗疗程结束时结肠癌进展。

经验教训

关于移植后CRC单药化疗的病例已有报道，但目前尚无双联化疗的经验。我们分享了FOLFOX用于一名移植后结肠癌患者的经验。未观察到与免疫抑制剂的不相容性或严重药物不良反应。它为移植后CRC的药物治疗提供了证据。