title: [A case of advanced colon cancer with atrial fibrillation and the use of dabigatran for safe chemotherapy using fluoropyrimidine-based antitumor agents].
abstract: A 77-year-old man with colon cancer and multiple metastases to the liver and lungs underwent resection of the primary tumor and D3 lymph node dissection. He presented with chronic atrial fibrillation; therefore, warfarin was used initially as an anticoagulant. Because of the need to administer a fluoropyrimidine-based antineoplastic agent[5-fluorouracil(5-FU)] during chemotherapy, we changed the anticoagulant from warfarin to dabigatran etexilate(dabigatran)before initiating chemotherapy. No complications or excessive decrease in coagulability was observed after changing the anticoagulant; chemotherapy was safely continued. Unlike warfarin, dabigatran undergoes renal excretion, and thus, can be safely used in anticoagulant therapy without any drug interaction with 5-FU. Thus, we believe that dabigatran may be the anticoagulant of choice in the future for cancer patients who are scheduled to undergo chemotherapy using fluoropyrimidine-based antineoplastic agents.
authors.affiliation: Dept. of Surgery, Iwakuni Medical Center.
authors.forename: Masao
authors.initials: M
authors.lastname: Nakajima
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Adachi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uchisako
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D001562:Benzimidazoles / Q000627:therapeutic use*; D003110:Colonic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D000069604:Dabigatran; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D011725:Pyridines / Q000627:therapeutic use*
chemical_list: D001562:Benzimidazoles; D009944:Organoplatinum Compounds; D011725:Pyridines; D000069604:Dabigatran; D002955:Leucovorin; D005472:Fluorouracil