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一名前列腺癌患者中与阿帕替尼相关的肠系膜动脉夹层动脉瘤:病例报告及文献综述

Mesenteric Artery Dissection Aneurysm Associated with Apatinib in a Prostate Cancer Patient: A Case Report and Literature Review.

作者信息

Ren Tiejun, Gu Jinjin, Wang Dingyi, Zhao Lijuan

机构信息

Oncology Special Ward, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, People's Republic of China.

出版信息

Res Rep Urol. 2025 Aug 6;17:263-270. doi: 10.2147/RRU.S523768. eCollection 2025.

Abstract

BACKGROUND

Apatinib mesylate, a VEGFR2 tyrosine kinase inhibitor, is approved for advanced liver, esophageal, gastric and other malignant tumors, but its adverse effects require attention. We report a 79-year-old male with prostatic adenocarcinoma who developed superior mesenteric artery dissecting aneurysm after combined apatinib and chemotherapy. Apatinib, an anti-angiogenic agent, synergizes with chemotherapy. After informed consent, the combination regimen was initiated. Two cycles later, the patient had tolerable intermittent abdominal pain, and CT confirmed the aneurysm. Due to progressive tumor and poor physical status, no further treatment was given as the aneurysm did not affect the disease course. This case report aims to provide insights into the safe application of apatinib in clinical practice.

MATERIALS AND METHODS

The materials for the literature review were gathered through a comprehensive search conducted on PubMed. Which yielded VEGFR2 treated for prostate cancer.

CASE REPORT

In this case report, a 79-year-old male with a height of 172 cms and a weight of 67 kgs who had been diagnosed with prostate adenocarcinoma for over three years. MRI scan indicated that bone metastases increased and enlarged compared with prior test. No significant abnormalities were observed in both physical and blood examinations. The pelvic MRI scan showed a prostatectomy changes, multiple abnormal signals in the bilateral ilium, acetabulum, femur, ischiatic bone, pubis, sacral vertebrae, and part of the lumbar vertebrae.

CONCLUSION

Antiangiogenic agents are being increasingly utilized in clinical practice. As clinicians, it is imperative to remain vigilant against potential complications such as arterial dissection and aneurysm, while conducting meticulous evaluations of associated risks. Notably, this article serves solely as a reference and does not advocate for the adjustment of treatment protocols on this basis.

摘要

背景

甲磺酸阿帕替尼是一种VEGFR2酪氨酸激酶抑制剂,已被批准用于治疗晚期肝癌、食管癌、胃癌及其他恶性肿瘤,但其不良反应需引起关注。我们报告一例79岁前列腺腺癌男性患者,在接受阿帕替尼联合化疗后发生肠系膜上动脉夹层动脉瘤。阿帕替尼作为一种抗血管生成药物,与化疗具有协同作用。在获得患者知情同意后,开始使用联合治疗方案。两个周期后,患者出现可耐受的间歇性腹痛,CT检查证实存在动脉瘤。由于肿瘤进展且身体状况较差,鉴于动脉瘤未影响病程,未给予进一步治疗。本病例报告旨在为阿帕替尼在临床实践中的安全应用提供见解。

材料与方法

通过对PubMed进行全面检索收集文献综述材料,检索词为“VEGFR2治疗前列腺癌”。

病例报告

本病例报告的患者为一名79岁男性,身高172厘米,体重67千克,已确诊前列腺腺癌三年多。MRI扫描显示与之前检查相比,骨转移灶增多且增大。体格检查和血液检查均未发现明显异常。盆腔MRI扫描显示前列腺切除术后改变,双侧髂骨、髋臼、股骨、坐骨、耻骨、骶椎及部分腰椎有多个异常信号。

结论

抗血管生成药物在临床实践中的应用越来越广泛。作为临床医生,在进行相关风险的细致评估时,必须警惕诸如动脉夹层和动脉瘤等潜在并发症。值得注意的是,本文仅作为参考,并不主张据此调整治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12335841/b111534ccb82/RRU-17-263-g0001.jpg

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