[Bevacizumab-induced reversible posterior leukoencephalopathy syndrome in a patient with metastatic colorectal cancer].
We report a rare case of a 67-year-old woman with metastatic colorectal cancer whose bevacizumab (B-mab) +m-FOLFOX6 treatment was complicated by reversible posterior leukoencephalopathy syndrome (RPLS). In July 2011, she underwent a right hemicolectomy for cecal carcinoma with peritoneal dissemination; therefore, m-FOLFOX6 was started in September 2011. In November 2011, she was hospitalized to add B-mab to the existing regimen. Subsequently, she developed hypertension on day 4 after the first B-mab infusion, followed by headache, convulsions, and disturbance of consciousness on day 5. T2-weighted and fluid-attenuated inversion recovery (FLAIR) non-enhanced magnetic resonance imaging of the brain revealed bilateral high signal intensities in the posterior lobes. She was diagnosed with RPLS and referred to our department where she was treated with antihypertensives and anticonvulsives. Her symptoms entirely resolved over 12 days. Medical oncologists should be aware that multidrug chemotherapies with B-mab may increase the risk of fatal neurological complications such as RPLS.
Department of Oncology, Japanese Red Cross Medical Center.
Shingo
S
Miyamoto
D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001063:Appendiceal Neoplasms / Q000473:pathology / Q000628:therapy*; D000068258:Bevacizumab; D003082:Colectomy; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D056784:Leukoencephalopathies / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D000927:Anticonvulsants; D000959:Antihypertensive Agents; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil