[A case of recurrent gastric cancer with dihydropyrimidine dehydrogenase (DPD) deficiency].
Dihydropyrimidine dehydrogenase (DPD) is a reducing enzyme for fluoropyrimidine which is a widely-used anti-cancer agent, and its deficiency leads to serious toxicities. We report a rare patient with a DPD deficiency. A 39-year-old man was suspected to have a gastric cancer recurrence from the elevation of CEA. Although TS-1 was administered for five days, it was stopped due to the development of grade 2 anorexia and nausea. Although we administered UFT at his request after a one-month drug rest, grade 1 stomatorrhagia besides the former adverse events developed after five days. Therefore he discontinued it and was admitted to our hospital. After 19 days, he died from multiple brain hemorrhage despite the intensive therapies. We considered that the congenital DPD deficiency caused the development of these adverse events because the DPD value was less than 5 pmol/mg/min in mononuclear cells of peripheral blood.
Hashimoto
Tatsuya
T
Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
Arai
Kuniyoshi
K
Iwasaki
Yoshiaki
Y
Saze
Zenichiro
Z
Takahashi
Keiichi
K
Yamaguchi
Tatsuro
T
Matsumoto
Hiroshi
H
Yasutome
Michiya
M
Hiruma
Kiyoshi
K
Yamashita
Yuichi
Y
D000328:Adult; D000855:Anorexia / Q000139:chemically induced; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000556:secondary; D002543:Cerebral Hemorrhage / Q000209:etiology; D054067:Dihydropyrimidine Dehydrogenase Deficiency; D004338:Drug Combinations; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D009325:Nausea / Q000139:chemically induced; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000201:enzymology* / Q000473:pathology; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects*; D014498:Uracil / Q000008:administration & dosage / Q000009:adverse effects
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C096910:UFT(R) drug; C079198:S 1 (combination); D005641:Tegafur; D014498:Uracil; D010094:Oxonic Acid