Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 14, 2012; 18(38): 5427-5433
Published online Oct 14, 2012. doi: 10.3748/wjg.v18.i38.5427
Oxaliplatin-induced severe anaphylactic reactions in metastatic colorectal cancer: Case series analysis
Jui-Ho Wang, Tai-Ming King, Min-Chi Chang, Chao-Wen Hsu
Jui-Ho Wang, Tai-Ming King, Min-Chi Chang, Chao-Wen Hsu, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veteran General Hospital, Kaohsiung 81346, Taiwan, China
Chao-Wen Hsu, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan, China
Author contributions: Hsu CW wrote the manuscript and Wang JH revised the manuscript; King TM, Chang MC collected the data on the cases.
Correspondence to: Dr. Chao-Wen Hsu, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veteran General Hospital, Kaohsiung 81346, Taiwan, China. ss851124@gmail.com
Telephone: +886-7-3422121 Fax: +886-7-3422121
Received: March 3, 2012
Revised: June 20, 2012
Accepted: July 9, 2012
Published online: October 14, 2012
Abstract

AIM: To investigate oxaliplatin-induced severe anaphylactic reactions (SAR) in metastatic colorectal cancer in a retrospective case series analysis and to conduct a systemic literature review.

METHODS: During a 6-year period from 2006 to 2011 at Kaohsiung Veterans General Hospital, a total of 412 patients exposed to oxaliplatin-related chemotherapy were retrospectively reviewed. Relevant English-language studies regarding life-threatening SAR following oxaliplatin were also reviewed in MEDLINE® and PubMed® search.

RESULTS: Eight patients (1.9%, 8 of 412 cases) were identified. Seven patients were successful resuscitated without any sequelae and one patient expired. We changed the chemotherapy regimen in five patients and rechallenged oxaliplatin use in patient 3. Twenty-three relevant English-language studies with 66 patients were reported. Patients received a median of 10 cycles of oxaliplatin (range, 2 to 29). Most common symptoms were respiratory distress (60%), fever (55%), and hypotension (54%). Three fatal events were reported (4.5%). Eleven patients (16%) of the 66 cases were rechallenged by oxaliplatin.

CONCLUSION: SAR must be considered in patients receiving oxaliplatin-related chemotherapy, especially in heavily pretreated patients. Further studies on the mechanism, predictors, preventive methods and management of oxaliplatin-related SAR are recommended.

Keywords: Oxaliplatin; Anaphylactic; Colorectal cancer; Metastasis