Folfiri, folfox4 and bevacizumab treatment in a patient on maintenance hemodialysis with advanced rectal cancer showing a submucosal tumor-like appearance

Abstract

A 57-year-old man undergoing maintenance hemodialysis for chronic renal failure was admitted for investigation of the cause of dyschezia. After endoscopic and radiological examinations, low-anterior resection was performed for advanced rectal cancer showing a submucosal tumor-like appearance. Seven months later, elevation of the serum CEA level and multiple lung metastases were found. The patient was administered FOLFIRI therapy (CPT-11 65mg/m²), followed by FOLFOX4 therapy (Oxaliplatin 32mg/m²), FOLFIRI therapy (CPT-11 80mg/m²) and finally, bevacizumab + FOLFOX4 therapy (bevacizumab 5mg/kg, oxaliplatin 85mg/m²), without severe side effects. A colorectal cancer presenting with a submucosal tumor-like appearance is rare and sometimes difficult to diagnose preoperatively. Although no standard adjuvant chemotherapy has been established for renal failure patients with colorectal cancer, we could safely administer the above-mentioned chemotherapies to this patient. Herein, we report this rare tumor and the valuable experience of chemotherapy in a chronic renal failure patient with colorectal cancer.