title: [A case of severe enteritis induced by adjuvant chemotherapy for colon cancer].
abstract: A 77-year-old man underwent surgery for sigmoid colon cancer. He was diagnosed with Stage IIIa colon cancer; there- fore, we initiated oral administration of adjuvant chemotherapy comprising uracil/tegafur(UFT)plus Leucovorin(LV). However, chemotherapy was stopped after 21 days because of fatigue and diarrhea. He recovered after 3 weeks, and we administered the same regimen with a dose reduction. However, he again experienced fatigue and diarrhea after 20 days; therefore, chemotherapy was discontinued. Subsequently, he was hospitalized 8 times for conditions such as diarrhea, hypoalbuminemia, and fever. Computed tomography revealed thickening of the transverse colonic wall and colonoscopy revealed colitis, which we believe was induced by UFT plus LV. Twelve months after the last chemotherapy session, he was diagnosed with Clostridium difficile colitis. Therefore, we initiated the oral administration of vancomycin, which resulted in rapid recovery from colitis. However, he developed liver metastasis and died 29 months after the initiation of chemotherapy. We believe that this severe case of intractable colitis was caused by UFT plus LV. Therefore, we report this case with a review of the literature on enteritis induced by fluorouracil-based anticancer agents in Japan.
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital.
authors.forename: Shumpei
authors.initials: S
authors.lastname: Mukai
authors.forename: Shungo
authors.initials: S
authors.lastname: Endo
authors.forename: Kenta
authors.initials: K
authors.lastname: Nakahara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takayanagi
authors.forename: Chiyo
authors.initials: C
authors.lastname: Maeda
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takehara
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Omoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Wada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kida
authors.forename: Eiji
authors.initials: E
authors.lastname: Hidaka
authors.forename: Fumio
authors.initials: F
authors.lastname: Ishida
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Tanaka
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Kudo
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D016360:Clostridioides difficile; D004751:Enteritis / Q000139:chemically induced* / Q000188:drug therapy / Q000382:microbiology; D017809:Fatal Outcome; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D009367:Neoplasm Staging; D012811:Sigmoid Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects; D014498:Uracil / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D005641:Tegafur; D014498:Uracil; D002955:Leucovorin