[Modified FOLFOX6 treatment for obstructive jaundice caused by hepatic lymph-node metastasis from liver metastases of rectal cancer--a case report].
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.
Ishiguro
Toru
T
Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
Kitaoka
Takashi
T
Sakimoto
Takehiko
T
Miyazaki
Tatsuya
T
Yokoyama
Masaru
M
Ishibashi
Keiichiro
K
Matsuki
Moriyuki
M
Inoue
Naohisa
N
Sano
Motohiko
M
Ishida
Hideyuki
H
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
D014408:Biomarkers, Tumor; D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil