PDF(Pubmed)
Abstract：
In this report, two cases of patients with severe adverse events after an adjuvant treatment with capecitabine are described in detail. The first patient suffered from a severe ileocolitis, where ultimately intensive care treatment, total colectomy and ileum resection was necessary. The second patient experienced a toxic enteritis, which could be managed conservatively. Post-therapeutic DPYD genotyping was negative in the former and positive in the latter case. Patients can be categorised in normal, moderate and poor DPYD metabolisers to predict the risk of adverse events of capecitabine treatment. Guidelines in various European countries recommend pretherapeutic DPYD genotyping, whereas it is not recommended by the National Comprehensive Cancer Network in the USA. Irrespective of DPYD genotyping, strict therapeutic drug monitoring is highly recommended to reduce the incidence and severity of adverse events.
摘要：
在这份报告中,本文详细描述了2例卡培他滨辅助治疗后出现严重不良事件的患者.第一个病人患有严重的回肠结肠炎,最终的重症监护治疗，全结肠切除术和回肠切除术是必要的。第二名患者出现了毒性肠炎,可以保守管理。治疗后DPYD基因分型在前者中为阴性，在后者中为阳性。患者可以分类为正常，中度和不良DPYD代谢物预测卡培他滨治疗不良事件的风险。不同欧洲国家的指南推荐治疗前DPYD基因分型，而美国国家综合癌症网络不推荐。不考虑DPYD基因分型，强烈建议严格的治疗药物监测,以降低不良事件的发生率和严重程度.
