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Japanese Journal of Clinical Oncology Advance Access published online on August 4, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym044
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© 2007 Foundation for Promotion of Cancer Research

Hepatic Arterial Infusion of Oxaliplatin for a Patient with Hepatic Metastases from Colon Cancer Undergoing Hemodialysis

Kohei Shitara1,, Masaki Munakata1, Osamu Muto1, Ristuko Okada1, Sumako Mitobe1, Masanari Mino2, Isao Ikami3 and Yuh Sakata1

1 Department of Medical Oncology, Misawa City Hospital, Misawa, Aomori
2 Department of Urology, Misawa City Hospital, Misawa, Aomori
3 Department of Radiology, Aomori Rosai Hospital, Misawa, Aomori, Japan

For reprints and all correspondence: Kohei Shitara, Misawa City Hospital, 4-1-10, Chyuuou-chyou, Misawa, Aomori, 033-0001 Japan. E-mail: Kouheis0824{at}yahoo.co.jp

Received November 9, 2006; accepted February 3, 2007

There has been no previous report of oxaliplatin administration in patients undergoing hemodialysis. A 65-year-old female with end-stage renal disease who was undergoing hemodialysis presented with anemia in August 2005. She was diagnosed with colon cancer with multiple liver metastases. After colectomy, hepatic arterial infusion chemotherapy of 5-fluorouracil was initiated and systemic administration of irinotecan was later added. After 3 months of treatment, liver metastases were strikingly reduced in size, and the carcinoembryonic antigen level decreased from 336 to 14.2 ng/ml. Eight months after treatment initiation, liver metastases increased in size with higher levels of carcinoembryonic antigen, therefore hepatic arterial infusion of oxaliplatin 60 mg was initiated. Hepatic arterial infusion was performed biweekly during hemodialysis and blood platinum concentrations were assessed. At the first cycle, the area under the curve of total platinum was 19.39 µg h/ml and that of free platinum was 5.51 µg h/ml. After six treatment cycles, the carcinoembryonic antigen level declined from 335 to 123 ng/ml. After eight treatment cycles, she experienced transient fever and impaired consciousness as a result of cholangitis, which improved following administration of antibiotics. We propose that limited cycles of hepatic arterial infusion of oxaliplatin are feasible in patients undergoing hemodialysis and this may become a strategy for treating hepatic metastases from colon cancer in patients undergoing hemodialysis.

Key Words: oxaliplatin • hepatic arterial infusion • hemodialysis


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