title: Capecitabine and oxaliplatin (XELOX) for the treatment of patients with metastatic gastric cancer and severe liver dysfunction.
abstract: Gastric cancer patients with severe liver dysfunction secondary to hepatic metastases have limited treatment options. Most cytotoxic drugs have a narrow therapeutic index. Although both capecitabine and oxaliplatin have been well tolerated as single agents for patients with severe hepatic dysfunction, the combination of these drugs has not been investigated. We report here on a case of successful treatment of a patient suffering with severe liver dysfunction and metastatic gastric cancer; the patient was treated with a combination of capecitabine and oxaliplatin (XELOX). The initial bilirubin level of the patient was 10.9 mg/dL. After two cycles of treatment, his bilirubin level decreased to 2.1 mg/dL. He has experienced an excellent radiological response and he has received six cycles of XELOX chemotherapy. XELOX chemotherapy is feasible and it can be associated with positive outcomes for the patients suffering with metastatic gastric cancer and severe liver dysfunction.
authors.affiliation: Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Korea.
authors.forename: Seung Jae
authors.initials: SJ
authors.lastname: Hwang
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Park
authors.forename: Sehe Dong
authors.initials: SD
authors.lastname: Lee
authors.forename: Gyong Jung
authors.initials: GJ
authors.lastname: Kim
authors.forename: Cheol Ho
authors.initials: CH
authors.lastname: Sin
authors.forename: Seung-Hyun
authors.initials: SH
authors.lastname: Nam
authors.forename: Bong-Seog
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary / Q000628:therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000069287:Capecitabine; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005472:Fluorouracil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D000077150:Oxaliplatin; D011355:Prodrugs; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D011355:Prodrugs; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil