Abe H, Tsunaga N, Yamashita S, Ishiguro K, Mitani I
Dept. of Obstetrics and Gynecology, Shuto General Hospital.
Gan To Kagaku Ryoho. 1997 Mar;24(5):619-24.
We encountered two chemotherapy cases related to anticancer drug-induced colitis. Case 1 was a 35-yo-female with a recurrence of ovarian cancer. She was treated with intraarterial infusion consisting of continuous 5-fluorouracil (250 mg/day 5 days/week x 4) following low-dose consecutive cisplatin (20 mg/day 5 days/ week x 1). The catheter was inserted into the abdominal aorta about 2 cm above the carina of the common iliac arteries. Six weeks after the start of chemotherapy, severe abdominal pain and melena occurred. Case 2 was a 68-yo-female with an endometrial cancer recurrence. The same intraarterial chemotherapy used in case 1 was was initiated. Four weeks after the start of chemotherapy, before intraarterial infusion of CDDP, she suffered from constipation and than diarrhea, abdominal pain and melena. Both cases were diagnosed as anticancer drug-induced colitis with the pathological findings from colon biopsy and the clinical course, and improved in about 1 month with the discontinuation of intraarterial infusion, fasting and TPN. Intraarterial infusion of only CDDP caused both patients no intestinal symptoms, so it is supposed that intraarterial infusion of 5-fluorouracil induced the colitis. Anticancer drug-induced colitis should be taken into consideration as a rare but possible course of chemotherapy-related complication with intraarterial infusion of 5-fluorouracil.
我们遇到了两例与抗癌药物性结肠炎相关的化疗病例。病例1是一名35岁女性，卵巢癌复发。她在接受低剂量连续顺铂（20mg/天，每周5天，共1周）治疗后，接受了由持续5-氟尿嘧啶（250mg/天，每周5天，共4周）组成的动脉内灌注治疗。导管插入腹主动脉，位于髂总动脉分叉上方约2cm处。化疗开始六周后，出现严重腹痛和黑便。病例2是一名68岁女性，子宫内膜癌复发。开始采用与病例1相同的动脉内化疗。化疗开始四周后，在动脉内输注顺铂之前，她出现便秘，随后出现腹泻、腹痛和黑便。根据结肠活检的病理结果和临床病程，两例均被诊断为抗癌药物性结肠炎，在停止动脉内输注、禁食和全胃肠外营养后约1个月病情好转。仅动脉内输注顺铂未导致两名患者出现肠道症状，因此推测动脉内输注5-氟尿嘧啶诱发了结肠炎。抗癌药物性结肠炎应被视为动脉内输注5-氟尿嘧啶化疗相关并发症中一种罕见但可能出现的情况。
