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Vol - 25, Issue - 9
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[This article belongs to Volume - 25, Issue - 9]
International Medical Journal
Journal ID
:
IMJ-31-08-2020-595
Total View
:
444
Title
:
The Uncommon Adverse Effect Case: Bevacizumab Associated Fistula on Advanced Stage Colorectal Adenocarsinoma Undergoing Anti-Vascular Endothelial Growth Factor Adjuvant Chemotherapy
Abstract
: Bevacizumab is a humanized monoclonal antibody that targets vascular endothelial growth factor and is used in the standard adjuvant chemotherapy regimens to treat metastatic colorectal cancer (CRC). It is the commonest antiangiogenesis agent to treat metastatic CRC. Venous thromboembolism, delayed wound healing, and spontaneous bowel perforation are the adverse events following bevacizumab treatment. According to the timing of Histula growth relative to operation and starting bevacizumab treatment, Histulas are possibly secondary to bevacizumab treatment rather than postoperative complications. We reported, a single uncommon case of bevacizumab related enterocutaneous Histula on 60 years old woman patient whose already been done R0 resection for left side colon cancer 2 years before. Adjuvant chemotherapy already been given 3 weeks after surgery (using FOLFOX 6 regiments). After 1 year follow up, multiple nodul liver metastase were found on Abdominal CT Scan, the treatment was continued with Hirst line anti-angiogenesis regiment (FOLFOX + Bevacizumab) for another 6 months. On the last cycle, low output enterocutaneous Histula was found from the laparotomy scar, the chemotherapy was interrupted for the last cycle. Conservative treatment was done, parenteral nutritions were started and spontaneous Histula healing could achieved after 10 days and no need for surgical intervention. A small, but significant percentage of CRC cases develop Bevacizumab-associated Histulas, which should be detected early and is managed conservatively
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