title: [Modified FOLFOX6 treatment for obstructive jaundice caused by hepatic lymph-node metastasis from liver metastases of rectal cancer--a case report].
abstract: Chemotherapy is potentially hazardous for patients with liver dysfunction. Although FOLFOX regimen is one of the standard chemotherapies for nonresectable liver metastases of colorectal cancer, the safety of this regimen has not been established yet in patients with obstructive jaundice associated with multiple liver metastases. We report a case of nonresectable liver metastases of rectal cancer treated by modified FOLFOX6 regimen after percutaneous transhepatic biliary drainage for obstructive jaundice, which was caused by hepatic lymph-node metastasis. Five days after giving a birth, a 32-year-old woman underwent Hartmann's procedure for perforation of rectal cancer associated with multiple liver metastases. She was admitted again to receive chemotherapy 35 days after surgery, but the level of total bilirubin was elevated (3.9 mg/dL). Since the total bilirubin level was not rapidly decreased after PTBD, the modified FOLFOX6 regimen was started with a 70% dose. After an introduction of mFOLFOX6 treatment, a biliary-stenting was successfully performed, and the mFOLFOX6 continued with a full dose starting from the 5th cycle. Although the therapeutic efficacy after an additional 8-cycle was classified as stable disease (SD), she did not show any sign of adverse effects except for grade 1 neurotoxicity.
authors.affiliation: Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitaoka
authors.forename: Takehiko
authors.initials: T
authors.lastname: Sakimoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Masaru
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Moriyuki
authors.initials: M
authors.lastname: Matsuki
authors.forename: Naohisa
authors.initials: N
authors.lastname: Inoue
authors.forename: Motohiko
authors.initials: M
authors.lastname: Sano
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D041781:Jaundice, Obstructive / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D002955:Leucovorin / Q000009:adverse effects / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000556:secondary*; D008207:Lymphatic Metastasis / Q000473:pathology; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil