内容紹介
Bevacizumab Therapy for a Colorectal Cancer Patient or Hemodialysis with Hepatic Metastasis
Summary
We report our experience with a case of colorectal cancer treated with chemotherapy for a liver metastasis patient on hemodialysis. The patient was a 67-year-old man with a history of chronic renal failure, who was on hemodialysis since 2005. High anterior resection was performed for sigmoid colon and rectal cancer in January, 2010. After starting chemotherapy while planning to use FOLFOX6+bevacizumab(BV)as a postoperative standard chemotherapy, in combination with hemodialysis three times a week while performing dose escalation, administration postponement was continued for myelosuppression that was considered to be the effect of oxaliplatin. Oxaliplatin was administered for only 2 courses, and was then changed to BV+sLV5FU2 therapy. We continued treating the metastases approximately on schedule. Imaging revealed, the liver metastases were CR because they had disappeared. The BV use case of the dialysis case had few reports, but was thought to be able to use it by careful administration safely.
要旨
今回,われわれは血液透析肝転移に対して大腸癌化学療法を施行し,CRを得られた1症例を経験したので報告する。症例は67歳,男性で慢性腎不全の既往があり,2005年より血液透析が施行されている。2010年1月肝転移を伴うS状結腸癌および直腸癌に対して高位前方切除術を施行した。術後化学療法としてFOLFOX6+bevacizumab(BV)を計画し,dose escalationを行いながら血液透析を週3回併用しつつ化学療法を開始したところ,oxaliplatinの影響と思われる骨髄抑制のため2コースのみの投与となりBV+sLV5FU2療法に変更となった。その後はほぼ予定どおり治療を継続し,肝転移は消失してCRと判断している。透析症例のBV使用症例は報告も少ないが,慎重な投与により安全に使用できると考えられた。
目次
Summary
We report our experience with a case of colorectal cancer treated with chemotherapy for a liver metastasis patient on hemodialysis. The patient was a 67-year-old man with a history of chronic renal failure, who was on hemodialysis since 2005. High anterior resection was performed for sigmoid colon and rectal cancer in January, 2010. After starting chemotherapy while planning to use FOLFOX6+bevacizumab(BV)as a postoperative standard chemotherapy, in combination with hemodialysis three times a week while performing dose escalation, administration postponement was continued for myelosuppression that was considered to be the effect of oxaliplatin. Oxaliplatin was administered for only 2 courses, and was then changed to BV+sLV5FU2 therapy. We continued treating the metastases approximately on schedule. Imaging revealed, the liver metastases were CR because they had disappeared. The BV use case of the dialysis case had few reports, but was thought to be able to use it by careful administration safely.
要旨
今回,われわれは血液透析肝転移に対して大腸癌化学療法を施行し,CRを得られた1症例を経験したので報告する。症例は67歳,男性で慢性腎不全の既往があり,2005年より血液透析が施行されている。2010年1月肝転移を伴うS状結腸癌および直腸癌に対して高位前方切除術を施行した。術後化学療法としてFOLFOX6+bevacizumab(BV)を計画し,dose escalationを行いながら血液透析を週3回併用しつつ化学療法を開始したところ,oxaliplatinの影響と思われる骨髄抑制のため2コースのみの投与となりBV+sLV5FU2療法に変更となった。その後はほぼ予定どおり治療を継続し,肝転移は消失してCRと判断している。透析症例のBV使用症例は報告も少ないが,慎重な投与により安全に使用できると考えられた。