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

作     者：D. J. Nelmes S. H. Gwynne 

作者机构：Singleton Oncology Department Singleton Hospital Swansea UK 

出 版 物：《Case Reports in Clinical Medicine》 (临床医学病理报告（英文）)

年 卷 期：2014年第3卷第5期

页      面：319-321页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Colorectal Cancer Bevacizumab Avastin Nasal Septal Perforation 

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.