Watanabe Hiroki, Ohira Gaku, Miyauchi Hideaki, Imanishi Shunsuke, Tochigi Toru, Maruyama Tetsuro, Hanaoka Toshiharu, Okada Koichiro, Matsubara Hisahiro
Dept. of Frontier Surgery, Graduate School of Medicine, Chiba University.
Gan To Kagaku Ryoho. 2018 Dec;45(13):2396-2398.
A 54-year-old man receiving dialysis for diabetic nephropathy underwent surgery for sigmoid cancer. Nine months later, he was diagnosed with multiple liver metastases. He underwent 2 courses of FOLFIRI plus panitumumab(Pmab)as first-line therapy, 15courses of capecitabine plus bevacizumab(Bmab)as second-line therapy, and 27 courses of Pmab as third-line therapy. He developed various complications throughout the disease course, such as heart disease, diabetic gangrene in both legs, and abscess of liver metastasis. The tumor marker levels after each event were higher than the previous event and subsequently decreased with the resumption of chemotherapy. However, after 27 courses of Pmab, his liver and para-aortic lymph node metastases exacerbated, and he ultimately died from a poor general condition at 42 months after the initial recurrence of liver metastasis. Evidence regarding the safety and pharmacokinetics of chemotherapy in dialysis patients is insufficient at present. Herein, we report a case of metastatic colon cancer in a patient on hemodialysis along with a literature review.
一名因糖尿病肾病接受透析治疗的54岁男性因乙状结肠癌接受了手术。九个月后,他被诊断出多发性肝转移。他接受了2个疗程的FOLFIRI联合帕尼单抗(Pmab)作为一线治疗,15个疗程的卡培他滨联合贝伐单抗(Bmab)作为二线治疗,以及27个疗程的Pmab作为三线治疗。在整个病程中,他出现了各种并发症,如心脏病、双下肢糖尿病坏疽和肝转移脓肿。每次事件后的肿瘤标志物水平均高于前一次事件,随后随着化疗的恢复而下降。然而,在接受27个疗程的Pmab后,他的肝脏和主动脉旁淋巴结转移加剧,最终在肝转移初次复发后的42个月因全身状况不佳死亡。目前关于透析患者化疗安全性和药代动力学的证据不足。在此,我们报告一例血液透析患者的转移性结肠癌病例并进行文献综述。