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[A Case That Was Complicated with Pulmonary Artery Thrombosis during Chemotherapy of the Regimen of CapeOX plus Bevacizumab against Recurrence of Colon Cancer].

Abstract
An 80-year-old woman with peritoneal dissemination after laparoscopic right hemicolectomy for appendicular carcinoma (mucinous adenocarcinoma, pT4aN1M0, stage Ⅲa)underwent CapeOX plus bevacizumab chemotherapy. The patient achieved stable disease over 5 courses of the treatment. Subjective and objective symptoms were not observed; however, chest computed tomography findings revealed a thrombus in the pulmonary artery that was considered to be associated with bevacizumab. Chemotherapy was discontinued, and anticoagulation therapy was initiated with heparin and then switched to apixaban. The thrombus resolved with treatment, but the patient died following an increase in peritoneal dissemination. CapeOX plus bevacizumab is a recommended colon cancer treatment, and even though it is generally considered safe, the side effects of bevacizumab include relatively rare occurrences of gastrointestinal perforation or thrombosis. The frequency of pulmonary embolism associated with bevacizumab is approximately 0.1%, and fatalities have been reported. The possibility of asymptomatic thrombosis warrants regular monitoring of this serious side effect in patients receiving bevacizumab. Early detection and prompt antithrombotic treatment are necessary to ensure patient safety and continued disease management.
AuthorsTomoki Hariu, Yoshito Nako, Akinobu Furutani, Shigeki Yamasaki, Takashi Kitade, Motomi Wakasa, Teruhisa Sonoyama
JournalGan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 45 Issue 13 Pg. 2330-2332 (Dec 2018) ISSN: 0385-0684 [Print] Japan
PMID30692454 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antineoplastic Agents, Immunological
  • Organoplatinum Compounds
  • Oxaliplatin
  • Bevacizumab
  • Capecitabine
Topics
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological (therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Bevacizumab (therapeutic use)
  • Capecitabine
  • Colonic Neoplasms (drug therapy)
  • Female
  • Humans
  • Neoplasm Recurrence, Local
  • Organoplatinum Compounds
  • Oxaliplatin
  • Pulmonary Artery
  • Thrombosis (etiology)

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