title: Pharmacodynamic study of the Saltz regimen for metastatic colorectal cancer in a hemodialyzed patient.
abstract: OBJECTIVE
  Combination therapy with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin is widely used for the treatment of metastatic colorectal cancer. However, little is known about the safety of chemotherapy of malignancies in hemodialysis (HD) patients. We encountered a patient with colorectal carcinoma on HD. We decided to administer combination chemotherapy while monitoring the pharmacodynamics of the patient.
  
  
  METHODS
  A 74-year-old male received regular HD 3 times a week because of type 1 diabetes mellitus. He was diagnosed with stage IV colorectal cancer in November 2004. After sigmoidectomy, the patient received chemotherapy: a weekly schedule of CPT-11 (50 mg/m(2)) was administered followed by l-leucovorin (10 mg/m(2)) and 5-FU (400 mg/m(2)) just after HD. During the course, the plasma concentrations of both SN-38, an active metabolite of CPT-11, and 5-FU were not increased compared with those of patients with normal renal function. Our patient presented with grade III hematological toxicity that was easily recovered by granulocyte colony-stimulating factor.
  
  
  CONCLUSIONS
  These data suggest that the dose-reduced Saltz regimen can be feasible for colorectal cancer patients receiving dialysis as postoperative adjuvant chemotherapy.
authors.affiliation: Department of Internal Medicine, Saiyu Kawaguchi Clinic, Saitama, Japan. ANC18271@nifty.com
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Akiyama
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Nakayama
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takami
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Gotoh
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Gotoh
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D006435:Renal Dialysis; D016896:Treatment Outcome
chemical_list: D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin