切除不能進行再発大腸癌の化学療法中に発症した消化管穿孔の後方視的研究

【はじめに】切除不能進行再発大腸癌の化学療法中に血管新生阻害薬による消化管穿孔は致死的有害事象である。切除不能進行再発大腸癌の化学療法中に発症した消化管穿孔を検討したので報告する。【対象と方法】2020年1月から2022年2月に当センターにおいて切除不能進行再発大腸癌に対して化学療法を行った症例を対象とし，後方視的に消化管穿孔を調査した。【結果】対象症例は55例。年齢中央値63.5（36〜89）歳，性別は男/女 31/24。化学療法開始時のPSは0/1/2が44/9/2例。Grade 3以上の消化管穿孔は2例（3.6％）であり，1例は抗菌薬で保存的に軽快し，1例は手術により大網充填と洗浄ドレナ...

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Published in日本腹部救急医学会雑誌 Vol. 43; no. 3; pp. 637 - 640
Main Authors 横野, 良典, 岩瀬, 和裕, 賀川, 義規
Format Journal Article
LanguageJapanese
Published 日本腹部救急医学会 31.03.2023
Subjects
化学療法
大腸癌
消化管穿孔
血管新生阻害剤
Online AccessGet full text
ISSN1340-2242
1882-4781
DOI10.11231/jaem.43.637

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Abstract 【はじめに】切除不能進行再発大腸癌の化学療法中に血管新生阻害薬による消化管穿孔は致死的有害事象である。切除不能進行再発大腸癌の化学療法中に発症した消化管穿孔を検討したので報告する。【対象と方法】2020年1月から2022年2月に当センターにおいて切除不能進行再発大腸癌に対して化学療法を行った症例を対象とし，後方視的に消化管穿孔を調査した。【結果】対象症例は55例。年齢中央値63.5（36〜89）歳，性別は男/女 31/24。化学療法開始時のPSは0/1/2が44/9/2例。Grade 3以上の消化管穿孔は2例（3.6％）であり，1例は抗菌薬で保存的に軽快し，1例は手術により大網充填と洗浄ドレナージを行った。治療関連死亡は認めなかった。【結語】化学療法に伴う消化管穿孔を2例経験した。1例は保存的に治癒し，1例は手術が必要であった。
AbstractList 【はじめに】切除不能進行再発大腸癌の化学療法中に血管新生阻害薬による消化管穿孔は致死的有害事象である。切除不能進行再発大腸癌の化学療法中に発症した消化管穿孔を検討したので報告する。【対象と方法】2020年1月から2022年2月に当センターにおいて切除不能進行再発大腸癌に対して化学療法を行った症例を対象とし，後方視的に消化管穿孔を調査した。【結果】対象症例は55例。年齢中央値63.5（36〜89）歳，性別は男/女 31/24。化学療法開始時のPSは0/1/2が44/9/2例。Grade 3以上の消化管穿孔は2例（3.6％）であり，1例は抗菌薬で保存的に軽快し，1例は手術により大網充填と洗浄ドレナージを行った。治療関連死亡は認めなかった。【結語】化学療法に伴う消化管穿孔を2例経験した。1例は保存的に治癒し，1例は手術が必要であった。
Author 賀川, 義規
横野, 良典
岩瀬, 和裕
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7) Roodhart JM, Langenberg MH, Witteveen E, et al: The molecular basis of class side effects due to treatment with inhibitors of the VEGF/VEGFR pathway. Curr Clin Pharmacol 2008; 3: 132-143.
15) Badgwell BD, Camp ER, Feig B, et al: Management of bevacizumab-associated bowel perforation: a case series and review of the literature. Ann Oncol 2008; 19: 577-582.
6) Choi YI, Lee SH, Ahn BK, et al: Intestinal perforation in colorectal cancers treated with bevacizumab (Avastin). Cancer Res Treat 2008; 40: 33-35.
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9) Hapani S, Chu D, Wu S: Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol 2009; 10: 559-568.
References_xml – reference: 11) Sliesoraitis S, Tawfik B: Bevacizumab-induced bowel perforation. J Am Osteopath Assoc 2011; 111: 437-441.
– reference: 4) Yamazaki K, Yuki S, Oki E, et al: Real-world evidence on second-line treatment of metastatic colorectal cancer using fluoropyrimidine, irinotecan, and angiogenesis inhibitor. Clinical Colorectal Cancer 2021; 20: e173-e184.
– reference: 1) Biller LH, Schrag D: Diagnosis and treatment of metastatic colorectal cancer: a review. JAMA 2021; 325: 669-685.
– reference: 3) Hansen TF, Qvortrup C, Pfeiffer P: Angiogenesis inhibitors for colorectal cancer. A review of the clinical data. Cancers (Basel) 2021; 13: 1031.
– reference: 5) Han ES, Monk BJ: What is the risk of bowel perforation associated with bevacizumab therapy in ovarian cancer? Gynecol Oncol 2007; 105: 3-6.
– reference: 15) Badgwell BD, Camp ER, Feig B, et al: Management of bevacizumab-associated bowel perforation: a case series and review of the literature. Ann Oncol 2008; 19: 577-582.
– reference: 9) Hapani S, Chu D, Wu S: Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol 2009; 10: 559-568.
– reference: 13) Akeel N, Toonsi WA: Gastrointestinal perforation with an intraluminal stent and bevacizumab use in advanced metastatic colorectal Cancer. Cureus 2021; 13: e12831.
– reference: 2) Baraniskin A, Buchberger B, Pox C, et al: Efficacy of bevacizumab in first-line treatment of metastatic colorectal cancer: a systematic review and meta-analysis. Eur J Cancer 2019; 106: 37-44.
– reference: 12) Saif MW, Mehra R: Incidence and management of bevacizumab-related toxicities in colorectal cancer. Expert Opin Drug Saf 2006; 5: 553-566.
– reference: 14) 大腸癌研究会編：大腸癌治療ガイドライン 医師用2022年版．東京，金原出版，2022．
– reference: 7) Roodhart JM, Langenberg MH, Witteveen E, et al: The molecular basis of class side effects due to treatment with inhibitors of the VEGF/VEGFR pathway. Curr Clin Pharmacol 2008; 3: 132-143.
– reference: 8) Han YN, Choi YJ, Rhie SJ: Tolerability on serious adverse events of first-line bevacizumab and cetuximab for RAS wild-type metastatic colorectal cancer: a systematic review and meta-analysis. Healthcare (Basel) 2022; 10: 217.
– reference: 6) Choi YI, Lee SH, Ahn BK, et al: Intestinal perforation in colorectal cancers treated with bevacizumab (Avastin). Cancer Res Treat 2008; 40: 33-35.
– reference: 10) Kabbinavar FF, Flynn PJ, Kozloff M, et al: Gastrointestinal perforation associated with bevacizumab use in metastatic colorectal cancer: results from a large treatment observational cohort study. Eur J Cancer 2012; 48: 1126-1132.
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SubjectTerms 化学療法
大腸癌
消化管穿孔
血管新生阻害剤
Title 切除不能進行再発大腸癌の化学療法中に発症した消化管穿孔の後方視的研究
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