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[A case of sigmoid colon cancer with temporary dysarthria associated with irinotecan].

Abstract
A40 -year-old woman visited our hospital with adenocaricinoma of the sigmoid colon with multiple liver metastases and ovarian metastasis. Because of a stenosis of the primary tumor, she underwent a colostomy before chemotherapy. 5-fluorouracil and irinotecan and leucovorin(FOLFIRI)was selected as first-line chemotherapy. At the start of chemotherapy, just after the end of irinotecan and leucovorin administration, the patient developed dysarthria. There were no neurological abnormalities or hematological abnormalities. The treatment was temporarily discontinued, and the dysarthria completely disappeared within 90 minutes. 5-fluorouracil was administered after the disappearance of dysarthria. Within 60 minutes of the administration of irinotecan and leucovorin at the second chemotherapy treatment, the patient developed dysarthria again. The patient had no neurological or hematological abnormalities. Magnetic resonance imaging(MRI)showed no abnormalities. The treatment was stopped and dysarthria disappeared within 60 minutes as it did the first time. At each time, no treatment for dysarthria was performed. This patient refused to continue irinotecan because of dysarthria. Therefore, chemotherapy without irinotecan was continued for the third time onward. In the previous literature, 8 cases of dysarthria caused by irinotecan were reported as a rare toxicity. In all cases, dysarthria was temporary and reversible. Because the mechanism of dysarthria is unclear, specific treatment and precaution for dysarthria is not recommended. Since dysarthria is reversible, however, irinotecan might be continued until progression.
AuthorsSusumu Sogabe, Satoshi Yuki, Hironobu Takano, Yoshimitsu Kobayashi, Hiroshi Nakatsumi, Takahide Sasaki, Yasuyuki Kawamoto, Hiraku Fukushima, Ichiro Iwanaga, Yasuko Uehata, Yoshito Komatsu, Masahiro Asaka
JournalGan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 38 Issue 8 Pg. 1375-7 (Aug 2011) ISSN: 0385-0684 [Print] Japan
PMID21829085 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Antineoplastic Agents, Phytogenic
  • Irinotecan
  • Leucovorin
  • Fluorouracil
  • Camptothecin
Topics
  • Antineoplastic Agents, Phytogenic (adverse effects, therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Camptothecin (adverse effects, analogs & derivatives, therapeutic use)
  • Dysarthria (chemically induced)
  • Female
  • Fluorouracil (adverse effects, therapeutic use)
  • Humans
  • Irinotecan
  • Leucovorin (adverse effects, therapeutic use)
  • Sigmoid Neoplasms (drug therapy)

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