title: [A case of metastatic colorectal cancer with icterus due to multiple liver metastases treated effectively by FOLFOX plus bevacizumab].
abstract: A 64-year-old male with fatigue and icterus was referred to our hospital. Computed tomography(CT)demonstrated multiple liver metastases and colonoscopic examination revealed advanced rectal cancer, which was diagnosed as moderately- differentiated adenocarcinoma without KRAS mutation. His serum total bilirubin level was 15.6 mg/dL. We started combination chemotherapy with 5-fluorouracil, Leucovorin and oxaliplatin(modified FOLFOX6)at a 20% lower than standard dosage for safety. When his bilirubin fell to 2.3 mg/dL after 4 courses of mFOLFOX6, the doses of 5-fluorouracil and oxaliplatin were increased to standard doses, and treatment with bevacizumab of 5 mg/kg every 2 weeks was begun. After another 3 courses of chemotherapy, his bilirubin was normalized to 0.8 mg/dL. No significant toxicity was observed. Combination chemotherapy with mFOLFOX6 plus bevacizumab was effective and feasible in this case of metastatic rectal cancer with icterus due to diffuse liver metastases.
authors.affiliation: Dept. of Surgery, NTT East Japan Tohoku Hospital.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Terasawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Koja
authors.forename: Koji
authors.initials: K
authors.lastname: Yasuda
authors.forename: Kaori
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007565:Jaundice / Q000209:etiology*; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil