Bowel Perforation Following Continuation of Bevacizumab Post Nasal Septal Perforation―A Case Report

• 作者: D. J. Nelmes S. H. Gwynne
• 来源期刊: 临床医学病理报告(英文)
• 学科: 医学
• 关键词: Colorectal Cancer BEVACIZUMAB AVASTIN NASAL SEPTAL PERFORATION
• 年，卷（期）: 2014,（5）
• 页码范围: 319-321
• 页数: 3页
• 分类号: R73

摘要

We report the case of a 63-year-old male with an inoperableT4N1 adenocarcinoma of colon, K-RAS mutant, who received first line chemotherapy with capecitabine and oxaliplatin. A CT scan following 4 cycles demonstrated progressive disease, and second line therapy with capecitabine, irinotecan and bevacizumab was commenced. CT scans at 3 and 6 months during this treatment regime demonstrated radiologically stable disease, and therefore the treatment was continued. The patient developed nasal septal perforation, a rare but recognised complication of bevacizumab therapy, which was managed conservatively. Here we highlight that no consensus exists on whether bevacizumab should be continued in this situation. After a detailed discussion about the risks and benefits, this patient continued on with the same therapeutic regime. However, eight weeks later, this patient then developed a localised tumour perforation, necessitating an emergency admission to his local hospital. We recommend caution in continuing bevacizumab in patients with colorectal cancer following a nasal septal perforation and advise a detailed discussion of risk with the patient, especially when the primary tumour remains in-situ.