RESUMO
Colorectal cancer is the third most common type of cancer worldwide, with >1 million cases diagnosed each year. Gastrointestinal bleeding is a common complication of colorectal cancer and is usually associated with the erosion and hemorrhage of the primary tumor. However, in patients who undergo a radical hemicolectomy and do not develop local recurrence, gastrointestinal bleeding may be a result of medical treatments or comorbidities. Esophageal bleeding in such patients is rare. Here, a case of severe esophageal bleeding due to anti-angiogenesis therapy with bevacizumab, and chemotherapy with the FOLFIRI regimen (irinotecan, folinic acid and 5-fluorouracil) in a patient with colorectal cancer is reported, and the possible pathogenesis of this event is analyzed based on the existing literature, in order to provide a reference for such cases.
RESUMO
Late-stage gastric adenocarcinoma patients have a poor prognosis because of high recurrence rates. To improve long-term outcomes, perioperative chemotherapies are combined with surgery. Human epidermal growth factor receptor 2 (HER2) overexpression had been noted in gastric cancer; therefore, trastuzumab has been used occasionally in this setting. A 63-year-old male Chinese patient, who was diagnosed with adenocarcinoma in the gastric antrum, as well as lymph node metastases along the left gastric and hepatic artery, and left adrenal area, was admitted to our hospital. HER2 expression was positive, and cluster amplification was detected in a fluorescence in situ hybridization assay. The patient received three cycles of a neoadjuvant trastuzumab/oxaliplatin /capecitabine regimen. He subsequently underwent distal gastrectomy, D2+ lymphadenectomy, left adrenalectomy, cholecystectomy and Billroth II anastomosis. Treatment was continued with another five postoperative cycles of the same medication and trastuzumab application for 1 year. No recurrence has been observed 18 mo after the operation. Trastuzumab as perioperative and adjuvant medication, in combination with oxaliplatin and capecitabine for a HER2-overexpressing advanced gastric adenocarcinoma, led to recurrence-free survival of at least 18 mo after surgery.
