内容紹介
A Case of Alcoholic Liver Disease Presenting as Prominent Accumulation of Ascites Associated with Liver Damage Due to CapeOX
Summary
A 75-year-old man with rectal cancer had consumed an average of 66 g of alcohol per day for 47 years. However, his liver function was within normal limits and his Child-Pugh classification was A before initiation of therapy. He underwent neoadjuvant chemoradiation and a low anterior resection. The patient then received CapeOX as an adjuvant therapy. During the fourth cycle of CapeOX, computed tomography(CT)showed massive ascites. The chemotherapy was discontinued and treatment including a diuretic agent was initiated. The ascites gradually decreased and 8 months after the discontinuation of CapeOX, CT showed neither the presence of ascites nor recurrence of the cancer or metastasis. When a patient has a history of excessive alcohol intake, even if test results for liver function are within normal limits, we should be aware of the hepatic toxicity of CapeOX.
要旨
症例は75歳,男性。過去に1日平均日本酒3合を47年間摂取していた。治療前の肝機能は正常であった。下部直腸癌に対して,術前化学放射線治療施行後に直腸低位前方切除術を施行した。術後補助療法としてCapeOXを開始したが,4コース目施行中にCTを施行したところ,著明な腹水貯留を認めた。化学療法を中止し,利尿剤を含む内服加療を施行したところ,腹水貯留は軽快した。化学療法中止後8か月後のCTでは腹水を認めず,転移・再発所見も認めなかった。治療前に肝機能が正常でも,アルコール多飲歴がある場合は注意が必要である。
目次
Summary
A 75-year-old man with rectal cancer had consumed an average of 66 g of alcohol per day for 47 years. However, his liver function was within normal limits and his Child-Pugh classification was A before initiation of therapy. He underwent neoadjuvant chemoradiation and a low anterior resection. The patient then received CapeOX as an adjuvant therapy. During the fourth cycle of CapeOX, computed tomography(CT)showed massive ascites. The chemotherapy was discontinued and treatment including a diuretic agent was initiated. The ascites gradually decreased and 8 months after the discontinuation of CapeOX, CT showed neither the presence of ascites nor recurrence of the cancer or metastasis. When a patient has a history of excessive alcohol intake, even if test results for liver function are within normal limits, we should be aware of the hepatic toxicity of CapeOX.
要旨
症例は75歳,男性。過去に1日平均日本酒3合を47年間摂取していた。治療前の肝機能は正常であった。下部直腸癌に対して,術前化学放射線治療施行後に直腸低位前方切除術を施行した。術後補助療法としてCapeOXを開始したが,4コース目施行中にCTを施行したところ,著明な腹水貯留を認めた。化学療法を中止し,利尿剤を含む内服加療を施行したところ,腹水貯留は軽快した。化学療法中止後8か月後のCTでは腹水を認めず,転移・再発所見も認めなかった。治療前に肝機能が正常でも,アルコール多飲歴がある場合は注意が必要である。