两阶段肝切除术后应用FOLFIRI方案联合阿柏西普治疗出现严重脑病、乳酸性酸中毒和高氨血症：一例报告
Severe Encephalopathy, Lactic Acidosis and Hyperammonaemia With FOLFIRI Plus Aflibercept After Two-stage Hepatectomy: A Case Report.
作者信息
Hara Yoshihiro, Miyamoto Yuji, Hiyoshi Yukiharu, Iwatsuki Masaaki, Baba Yoshifumi, Yoshida Naoya, Baba Hideo
机构信息
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
出版信息
In Vivo. 2019 Mar-Apr;33(2):563-565. doi: 10.21873/invivo.11511.
Abstract
BACKGROUND/AIM: Recent advances in chemotherapy have increased the possibility of conversion hepatectomy for patients with initially unresectable liver metastases. Although long-term chemotherapy and subsequent extensive hepatectomy are becoming more common, the toxicities of such chemotherapies are unclear.
PATIENTS AND METHODS
We present a case report of a patient with metastatic colorectal cancer who developed severe encephalopathy with lactic acidosis and hyperammonaemia caused by 5-fluorouracil-based chemotherapy. Administration of vitamin B1 and continuous haemodiafiltration rapidly improved the patient's symptoms.
CONCLUSION
Intensive treatment of metastatic colorectal cancer patients with 5-fluorouracil can induce rare adverse events.
摘要
背景/目的：化疗方面的最新进展增加了对初始不可切除肝转移患者进行肝切除术转化治疗的可能性。尽管长期化疗及随后的广泛肝切除术越来越普遍，但此类化疗的毒性尚不清楚。
患者与方法
我们报告一例转移性结直肠癌患者，其因基于5-氟尿嘧啶的化疗发生严重脑病并伴有乳酸酸中毒和高氨血症。给予维生素B1及持续血液透析滤过迅速改善了患者症状。
结论
对转移性结直肠癌患者进行5-氟尿嘧啶强化治疗可引发罕见不良事件。
相似文献
1
Severe Encephalopathy, Lactic Acidosis and Hyperammonaemia With FOLFIRI Plus Aflibercept After Two-stage Hepatectomy: A Case Report.两阶段肝切除术后应用FOLFIRI方案联合阿柏西普治疗出现严重脑病、乳酸性酸中毒和高氨血症：一例报告
In Vivo. 2019 Mar-Apr;33(2):563-565. doi: 10.21873/invivo.11511.
2
Posterior Reversible Encephalopathy Syndrome During Treatment with Aflibercept, 5-Fluorouracil, Leucovorin, and Irinotecan for Metastatic Colorectal Cancer.使用阿柏西普、5-氟尿嘧啶、亚叶酸钙和伊立替康治疗转移性结直肠癌期间发生的后部可逆性脑病综合征
J Gastrointest Cancer. 2019 Mar;50(1):123-126. doi: 10.1007/s12029-017-9986-x.
3
Aflibercept Plus FOLFIRI in the Real-life Setting: Safety and Quality of Life Data From the Italian Patient Cohort of the Aflibercept Safety and Quality-of-Life Program Study.阿柏西普联合 FOLFIRI 真实世界研究：来自阿柏西普安全性和生活质量研究意大利患者队列的安全性和生活质量数据。
Clin Colorectal Cancer. 2018 Sep;17(3):e457-e470. doi: 10.1016/j.clcc.2018.03.002. Epub 2018 Mar 8.
4
Aflibercept versus placebo in combination with fluorouracil, leucovorin and irinotecan in the treatment of previously treated metastatic colorectal cancer: prespecified subgroup analyses from the VELOUR trial.阿柏西普联合氟尿嘧啶、亚叶酸钙和伊立替康治疗既往治疗的转移性结直肠癌：VELOUR 试验的预先指定亚组分析。
Eur J Cancer. 2014 Jan;50(2):320-31. doi: 10.1016/j.ejca.2013.09.013. Epub 2013 Oct 16.
5
Aflibercept for metastatic colorectal cancer: safety data from the Spanish named patient program.阿柏西普用于转移性结直肠癌：来自西班牙指定患者项目的安全性数据。
Expert Opin Drug Saf. 2015 Aug;14(8):1171-9. doi: 10.1517/14740338.2015.1057495. Epub 2015 Jun 16.
6
Observed benefit and safety of aflibercept in elderly patients with metastatic colorectal cancer: An age-based analysis from the randomized placebo-controlled phase III VELOUR trial.在转移性结直肠癌老年患者中观察到阿柏西普的获益和安全性：来自随机安慰剂对照 III 期 VELOUR 试验的基于年龄的分析。
J Geriatr Oncol. 2018 Jan;9(1):32-39. doi: 10.1016/j.jgo.2017.07.010. Epub 2017 Aug 12.
7
Time course of safety and efficacy of aflibercept in combination with FOLFIRI in patients with metastatic colorectal cancer who progressed on previous oxaliplatin-based therapy.既往奥沙利铂治疗进展的转移性结直肠癌患者中，阿柏西普联合 FOLFIRI 的安全性和疗效的时间进程。
Eur J Cancer. 2015 Jan;51(1):18-26. doi: 10.1016/j.ejca.2014.10.019. Epub 2014 Nov 14.
8
Necrotising fasciitis in a patient treated with FOLFIRI-aflibercept for colorectal cancer: a case report.一名接受FOLFIRI-阿柏西普治疗的结直肠癌患者发生坏死性筋膜炎：病例报告
Ann R Coll Surg Engl. 2017 Nov;99(8):e225-e226. doi: 10.1308/rcsann.2017.0143. Epub 2017 Aug 3.
9
Fluorouracil, leucovorin and irinotecan associated with aflibercept can induce microscopic colitis in metastatic colorectal cancer patients.氟尿嘧啶、亚叶酸钙和伊立替康联合阿柏西普可诱导转移性结直肠癌患者发生显微镜下结肠炎。
Invest New Drugs. 2015 Dec;33(6):1263-6. doi: 10.1007/s10637-015-0295-6. Epub 2015 Oct 22.
10
Safety and efficacy of aflibercept in combination with fluorouracil, leucovorin and irinotecan in the treatment of Asian patients with metastatic colorectal cancer.阿柏西普联合氟尿嘧啶、亚叶酸钙和伊立替康治疗亚洲转移性结直肠癌患者的安全性和有效性。
Asia Pac J Clin Oncol. 2016 Sep;12(3):275-83. doi: 10.1111/ajco.12496. Epub 2016 Apr 14.
引用本文的文献
1
Fluoropyrimidine usage in cases with hyperammonemia: real-world data study using the Japanese Adverse Drug Event Report (JADER) database.在高血氨症病例中使用氟嘧啶类药物：使用日本药物不良反应报告（JADER）数据库的真实世界数据研究。
Cancer Chemother Pharmacol. 2023 Jul;92(1):7-14. doi: 10.1007/s00280-023-04542-7. Epub 2023 May 19.
2
A Rare Case of Severe Lactic Acidosis from 5-Fluorouracil after mFOLFOX6 Treatment in a Patient with Advanced Gastric Cancer.晚期胃癌患者接受mFOLFOX6治疗后发生5-氟尿嘧啶所致严重乳酸酸中毒1例罕见病例
Case Rep Oncol. 2021 Mar 22;14(1):545-549. doi: 10.1159/000514296. eCollection 2021 Jan-Apr.
3
Successful management of hyperammonemia with hemodialysis on day 2 during 5-fluorouracil treatment in a patient with gastric cancer: a case report with 5-fluorouracil metabolite analyses.一名胃癌患者在接受5-氟尿嘧啶治疗第2天通过血液透析成功管理高氨血症：一份伴有5-氟尿嘧啶代谢物分析的病例报告
Cancer Chemother Pharmacol. 2020 Nov;86(5):693-699. doi: 10.1007/s00280-020-04158-1. Epub 2020 Oct 3.
本文引用的文献
1
Acute hyperammonemic encephalopathy after fluoropyrimidine-based chemotherapy: A case series and review of the literature.氟尿嘧啶类化疗后急性高氨血症性脑病：病例系列及文献综述
Medicine (Baltimore). 2017 Jun;96(22):e6874. doi: 10.1097/MD.0000000000006874.
2
Acute hyperammonemic encephalopathy after 5-fluorouracil based chemotherapy.基于5-氟尿嘧啶的化疗后急性高氨血症性脑病
Ann Surg Treat Res. 2016 Mar;90(3):179-82. doi: 10.4174/astr.2016.90.3.179. Epub 2016 Feb 26.
3
Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer.转移性结直肠癌的 FOLFOXIRI 和贝伐珠单抗初始治疗。
N Engl J Med. 2014 Oct 23;371(17):1609-18. doi: 10.1056/NEJMoa1403108.
4
Chemotherapy and targeted therapy for patients with initially unresectable colorectal liver metastases, focusing on conversion hepatectomy and long-term survival.初诊不可切除的结直肠癌肝转移患者的化疗和靶向治疗，重点关注转化性肝切除术和长期生存。
Ann Surg Oncol. 2014 Jun;21 Suppl 3:S405-13. doi: 10.1245/s10434-014-3577-x. Epub 2014 Feb 26.
5
Severe encephalopathy, lactic acidosis, vegetative instability and neuropathy with 5-Fluorouracil treatment - pyrimidine degradation defect or beriberi?5-氟尿嘧啶治疗导致的严重脑病、乳酸酸中毒、植物神经功能不稳定和神经病变——嘧啶降解缺陷还是脚气病？
Case Rep Oncol. 2011 May;4(2):371-6. doi: 10.1159/000328803. Epub 2011 Aug 10.
6
Encephalopathy, lactic acidosis, hyperammonaemia and 5-fluorouracil toxicity.脑病、乳酸性酸中毒、高氨血症和5-氟尿嘧啶毒性。
Br J Cancer. 1998 May;77(10):1710-2. doi: 10.1038/bjc.1998.282.
7
High-dose 5-fluorouracil infusional therapy is associated with hyperammonaemia, lactic acidosis and encephalopathy.高剂量5-氟尿嘧啶输注疗法与高氨血症、乳酸性酸中毒和脑病有关。
Br J Cancer. 1997;75(3):464-5. doi: 10.1038/bjc.1997.79.
Zotero 插件