PDF(Pubmed)
Abstract：
Regorafenib is a multikinase inhibitor approved for treatment of patients with metastatic Colo-Rectal Cancer (mCRC) and Gastro-Intestinal Stromal Tumor (GIST) progression after the administration of other tyrosine-kinase inhibitors such as imatinib and sunitinib. Only a handful of severe side effects such as intestinal perforations and fistulas have been described in the literature in patients undergoing multikinase inhibitor treatment. We report a case of a patient with peritoneal mCRC who experienced an intestinal perforation during the administration of Regorafenib and review the literature. A 48-year-old man with previously resected sigmoid colon cancer and peritoneal metastatic disease under Regorafenib treatment presented to our Emergency Department with severe abdominal pain and asthenia. Abdominal X-ray and contrast-enhanced computed tomography examination revealed an intestinal perforation. The patient underwent emergency surgery which demonstrated acute diffuse peritonitis, necrosis, and perforation of a distal ileal loop affected by peritoneal metastatic disease. The necrosis of peritoneal implants on bowel walls could be regarded as a potential factor leading to intestinal perforation in metastatic colorectal cancer patients undergoing Regorafenib treatment complaining of severe abdominal pain and asthenia. Surgeons, radiologists and oncologists should always keep in mind this rare adverse event during Regorafenib administration. Appropriate diagnostic tests and treatments should be carried out.
摘要：
Regorafenib是一种多激酶抑制剂，在施用其他酪氨酸激酶抑制剂（例如伊马替尼和舒尼替尼）后，被批准用于治疗转移性结肠直肠癌（mCRC）和胃肠道间质瘤（GIST）进展的患者。在接受多激酶抑制剂治疗的患者中，文献中仅描述了少数严重的副作用，例如肠穿孔和瘘。我们报告一例腹膜mCRC患者在服用Regorafenib期间发生肠穿孔，并复习文献。一名48岁的男子先前在Regorafenib治疗下切除了乙状结肠癌和腹膜转移性疾病，他因严重的腹痛和虚弱而被送往我们的急诊科。腹部X射线和对比增强计算机断层扫描检查显示肠穿孔。患者接受了急诊手术，表现为急性弥漫性腹膜炎，坏死,和受腹膜转移性疾病影响的远端回肠环穿孔。在接受Regorafenib治疗的转移性结直肠癌患者中，肠壁上的腹膜植入物坏死可被视为导致肠穿孔的潜在因素，这些患者抱怨严重的腹痛和无力。外科医生,放射科医师和肿瘤学家应始终牢记瑞戈拉非尼给药期间这一罕见的不良事件.应进行适当的诊断测试和治疗。
