AI Article Synopsis
- An 80-year-old man diagnosed with advanced rectal cancer underwent surgery and was treated with a combination chemotherapy of mFOLFOX6 and panitumumab.
- On day 3 of chemotherapy, he experienced confusion, and tests revealed elevated ammonia levels, leading to a diagnosis of 5-FU-induced hyperammonemic encephalopathy.
- After stopping high-dose 5-FU and administering branched-chain amino acids, his condition improved, but he later requested to switch chemotherapy regimens, moving to CPT-11 with panitumumab.
Article Abstract
An 80-year-old man underwent laparoscopic rectal high anterior resection with perineal dissemination for the management of RS rectal cancer. Following the diagnosis of RS rectal cancer with muc, pT4a, N3(14/15), M1c, P1, pStage Ⅳc, RAS/BRAF: wild type, treatment was initiated with mFOLFOX6 plus panitumumab(Pmab). Laboratory examination on admission revealed mild renal dysfunction(Cr 1.45 mg/dL). The patient became confused on day 3 of chemotherapy(JCS Ⅲ-200). Furthermore, laboratory findings revealed a serum ammonia level of 338μg/dL. He was diagnosed with 5-FU- induced hyperammonemic encephalopathy. Discontinuation of high-dose 5-FU and branched-chain amino acid solutions improved his mental status and decreased serum ammonia levels. We switched his chemotherapy regime to CPT-11 plus Pmab, but it was discontinued after 1 course on his request.
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