Gan to kagaku ryoho. Cancer & chemotherapy · 2021
[A Case of Hyperammonemic Encephalopathy following mFOLFOX6 plus Panitumumab Therapy for Rectal Cancer].
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Tsujio Gen, Muguruma Kazuya, Eguchi Shimpei, Iseki Yasuhito, Miki Yuichiro, Yoshii Mami, Fukuoka Tatsunari, Tamura Tatsuro, Shibutani Masatsune, Nagahara Hisashi, Toyokawa Takahiro, Tanaka Hiroaki, Lee Shigeru, Yashiro Masakazu, Ohira Masaichi
Аннотация
An 80-year-old man underwent laparoscopic rectal high anterior resection with perineal dissemination for the management of RS rectal cancer. Following the diagnosis of RS rectal cancer with muc, pT4a, N3(14/15), M1c, P1, pStage Ⅳc, RAS/BRAF: wild type, treatment was initiated with mFOLFOX6 plus panitumumab(Pmab). Laboratory examination on admission revealed mild renal dysfunction(Cr 1.45 mg/dL). The patient became confused on day 3 of chemotherapy(JCS Ⅲ-200). Furthermore, laboratory findings revealed a serum ammonia level of 338μg/dL. He was diagnosed with 5-FU- induced hyperammonemic encephalopathy. Discontinuation of high-dose 5-FU and branched-chain amino acid solutions improved his mental status and decreased serum ammonia levels. We switched his chemotherapy regime to CPT-11 plus Pmab, but it was discontinued after 1 course on his request.