Efficacy of XELOX plus Bevacizumab in Brain Metastasis from Rectal Cancer
A 62-year-old man was referred to our hospital with abdominal fullness and gait disturbance. Barium enema revealed a nearly obstructing tumor in the rectum. Stenosis prevented the endoscope from passing through. The patient needed a fasting because of stenosis of the rectum. Abdominal computed tomography (CT) revealed more than 10 hepatic metastases. Head CT and MRI showed two cerebellar metastases (fig. ). The patient underwent a resection of BM and loop transverse colostomy. We started XELOX + BV [BV (7.5 mg/kg) and oxaliplatin (130 mg/m2) on day 1 plus capecitabine (1,000 mg/m2) twice daily on days 1–14, every 3 weeks] which was administered on postoperative day 28 []. After 4 cycles of XELOX + BV, CT and MRI showed a reduction in tumor size (fig. ). Laboratory studies revealed a serum carcinoembryonic antigen (CEA) level of 3,460 ng/ml, which improved to 936 ng/ml after 4 cycles of chemotherapy. Observed adverse events that had appeared before were only a peripheral neuropathy in the acute stage (grade 1) and hand-foot syndrome (grade 1). Hematological toxicity, surgical site infection and incisional hernia were not noted.\nAfter 8 months, tumor progression has not occurred, and the patient is still undergoing therapy with XELOX + BV.