Pissarra Ana, Malheiro Mariana, Matos Leonor Vasconcelos, Plácido Ana Neto
Medical Oncology, Hospital de São Francisco Xavier, Lisbon, Lisbon, Portugal.
BMJ Case Rep. 2019 Apr 16;12(4):e228673. doi: 10.1136/bcr-2018-228673.
Colorectal cancer is the third most common cancer in men and the second in women. The standard chemotherapy regiment in stage III colon cancer is based in oxaliplatin. The most common side effects include neutropenia, peripheral neuropathy, vomiting and diarrhoea. Rhabdomyolysis due to oxaliplatin is rare, and there are no established guidelines for managing this adverse event. This report describes a case of a 52-year-old man, with a resected stage III colon cancer that started postoperative adjuvant chemotherapy with capecitabine plus oxaliplatin. After the second cycle, the patient developed distal muscle pain and weakness, with a total inability to walk. Blood tests showed an elevated creatine kinase and renal injury. Severe drug-related rhabdomyolysis was diagnosed. The goal of this case report is to discuss the side effect of adjuvant chemotherapy, given its rarity and severity.
结直肠癌是男性中第三常见、女性中第二常见的癌症。III期结肠癌的标准化疗方案以奥沙利铂为基础。最常见的副作用包括中性粒细胞减少、周围神经病变、呕吐和腹泻。奥沙利铂引起的横纹肌溶解很少见，且尚无针对该不良事件的既定管理指南。本报告描述了一名52岁男性病例，该患者患有已切除的III期结肠癌，术后开始使用卡培他滨加奥沙利铂进行辅助化疗。在第二个周期后，患者出现远端肌肉疼痛和无力，完全无法行走。血液检查显示肌酸激酶升高和肾损伤。诊断为严重的药物相关性横纹肌溶解。鉴于该副作用的罕见性和严重性，本病例报告的目的是讨论辅助化疗的副作用。
