Hemorrhagic stroke as a consequence of colorectal cancer treatment with monoclonal antibody
DOI:
https://doi.org/10.33448/rsd-v13i12.47718Keywords:
Cerebrovascular accident; Monoclonal antibody; Colorectal cancer; Neoplasm; Chemotherapy.Abstract
Colorectal cancer is a neoplasm that affects the gastrointestinal system and has been increasingly diagnosed in Brazil, especially in adults with a family history. It has high morbidity and mortality, causing complications, one of which is hemorrhagic stroke (hstroke). This study aimed to analyze the occurrence of hstroke in a patient with colorectal neoplasia and undergoing chemotherapy and monoclonal antibody treatment. The methodology adopted for the preparation of this work followed a descriptive and qualitative approach, a case report, with emphasis on the detailed analysis of the clinical conditions, diagnosis, and treatment of a patient hospitalized, from February 20, 2023 to March 4, 2023, in a hospital located in the city of Barreirinhas, Maranhão (MA), Brazil. This was a 42-year-old patient diagnosed with metastatic colorectal cancer, who presented seizures and epistaxis at home, and, after hospital investigation, the diagnosis of hstroke was made. The literature review showed that, although cerebrovascular complications are not the main causes of death in these patients, they are of special clinical interest, since they are not common. It was concluded that there is a need for further investigation of this type of complication in this subpopulation of patients, especially in the context of chemotherapy treatment, which can directly affect vascular function and increase the risk of hemorrhagic events.
References
Al-Samkari, H. (2022). Thrombopoietin receptor agonists for chemotherapy-induced thrombocytopenia: A new solution for an old problem. Hematology. American Society of Hematology. Education Program, 2022(1), 286–295. https://doi.org/10.1182/hematology.2022000374
Alves, N. S., & Paz, F. A. do N. (2019). Análise das principais sequelas observadas em pacientes vítimas de acidente vascular cerebral — AVC. REVISTA DA FAESF, 2(4). https://doi.org/10.58969/25947125.2.4.2018.66
Barguena, R. de O. (2019). O recurso da tomografia de crânio em pacientes oncológicos que buscam o pronto-atendimento hospitalar [Dissertação de Mestrado, Universidade Nove de Julho]. Biblioteca Digital de Teses e Dissertações da Universidade Nove de Julho. http://bibliotecatede.uninove.br/handle/tede/2993
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 68(6), 394–424. https://doi.org/10.3322/caac.21492
Costa, L. R. M. (2014). Acidente vascular cerebral em pacientes com doença oncológica - Estudo retrospetivo no CHCB [Dissertação de Mestrado, Universidade da Beira Interior]. Repositório Digital da Universidade da Beira Interior. https://ubibliorum.ubi.pt/handle/10400.6/4992
Dardiotis, E., Aloizou, A.-M., Markoula, S., Siokas, V., Tsarouhas, K., Tzanakakis, G., Libra, M., Kyritsis, A. P., Brotis, A. G., Aschner, M., Gozes, I., Bogdanos, D. P., Spandidos, D. A., Mitsias, P. D., & Tsatsakis, A. (2019). Cancer-associated stroke: Pathophysiology, detection and management (Review). International Journal of Oncology, 54(3), 779–796. https://doi.org/10.3892/ijo.2019.4669
Instituto Nacional de Câncer. (2022). Estimativa 2023: Incidência de câncer no Brasil. Ministério da Saúde. https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2023.pdf
Lee, Y. C., & Wu, W. J. (2021). Complications of Colorectal Cancer and Its Treatments. In Colorectal Cancer: From Pathogenesis to Treatment (pp. 239-255). Springer.
Lima, J. F. de, Macedo, A. B., Panizzon, C. P. do N. B., & Perles, J. V. C. M. (2019). Câncer colorretal, diagnóstico e estadiamento: revisão de literatura. Arquivos do Mudi, 23(3), 315-329. https://doi.org/10.4025/arqmudi.v23i3.51555
Lobo, F. L. da R., Del Giglio, A., & Aguiar, P. da C. (2020). Perfil epidemiológico do câncer colorretal. Clinical Oncology Letters. https://doi.org/10.4322/col.2019.005
Lyra, V. M. O. (2013). Crises epilépticas tardias após acidente vascular cerebral [Trabalho de Conclusão de Curso, Universidade Federal da Bahia]. Repositório Institucional da Universidade Federal da Bahia. https://repositorio.ufba.br/handle/ri/13572
Man, S., Zou, J., Wang, M., Liang, F., Chen, S., Zhang, X., & Li, X. (2016). A meta-analysis of contrast-enhanced computer tomography in the diagnosis of colorectal cancer. Journal of Cancer Research and Therapeutics, 12(Supplement), 79–81. https://doi.org/10.4103/0973-1482.191639
Manfredi, S., Lepage, C., Hatem, C., Coatmeur, O., Faivre, J., & Bouvier, A.-M. (2006). Epidemiology and management of liver metastases from colorectal cancer. Annals of Surgery, 244(2), 254–259. https://doi.org/10.1097/01.sla.0000217629.94941.cf
Melo, M. M., Cardoso, R. M., & Silva, M. J. S. da. (2017). Adverse drug reaction: A comparative analysis of protocols used for treatment of colorectal cancer. Medicina (Ribeirão Preto), 50(4), 245-254. https://doi.org/10.11606/issn.2176-7262.v50i4p245-254
Navi, B. B., Reiner, A. S., Kamel, H., Iadecola, C., Elkind, M. S. V., Panageas, K. S., & DeAngelis, L. M. (2015). Association between incident cancer and subsequent stroke. Annals of Neurology, 77(2), 291–300. https://doi.org/10.1002/ana.24325
O’Connell, C., Escalante, C. P., Goldhaber, S. Z., McBane, R., Connors, J. M., & Raskob, G. E. (2021). Treatment of Cancer-Associated Venous Thromboembolism with Low-Molecular-Weight Heparin or Direct Oral Anticoagulants: Patient Selection, Controversies, and Caveats. The Oncologist, 26(1), e8–e16. https://doi.org/10.1002/onco.13584
Ording, A. G., Søgaard, M., Skjøth, F., Grove, E. L., Lip, G. Y. H., Larsen, T. B., & Nielsen, P. B. (2022). Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer. Research and Practice in Thrombosis and Haemostasis, 6(1), e12629. https://doi.org/10.1002/rth2.12629
Portaria nº 958, de 26 de setembro de 2014. (2014, 26 de setembro). Aprova as Diretrizes Diagnósticas e Terapêuticas do Câncer de Cólon e Reto. Ministério da Saúde. https://www.gov.br/conitec/pt-br/midias/artigos_publicacoes/ddt_colorretal__26092014.pdf/view
Produtos Roche Químicos e Farmacêuticos S.A. (2024). Avastin®: Bula para pacientes (Bevacizumabe), solução injetável 25 mg/mL (4 mL e 16 mL). Produtos Roche Químicos e Farmacêuticos S.A. Retrieved from Roche Brasil.
Pucci, M., Moschetti, M., Urzì, O., Loria, M., Conigliaro, A., Di Bella, M. A., Crescitelli, R., Olofsson Bagge, R., Gallo, A., Santos, M. F., Puglisi, C., Forte, S., Lorico, A., Alessandro, R., & Fontana, S. (2023). Colorectal cancer-derived small extracellular vesicles induce TGFβ1-mediated epithelial to mesenchymal transition of hepatocytes. Cancer Cell International, 23(1), 77. https://doi.org/10.1186/s12935-023-02916-8
Punt, C. J. A., Buyse, M., Köhne, C.-H., Hohenberger, P., Labianca, R., Schmoll, H. J., Påhlman, L., Sobrero, A., & Douillard, J.-Y. (2007). Endpoints in adjuvant treatment trials: A systematic review of the literature in colon cancer and proposed definitions for future trials. Journal of the National Cancer Institute, 99(13), 998–1003. https://doi.org/10.1093/jnci/djm024
Resolução nº 466, de 12 de dezembro de 2012. (2012, 12 de dezembro). Aprova as seguintes diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Conselho Nacional de Saúde. https://www.gov.br/conselho-nacional-de-saude/pt-br/acesso-a-informacao/legislacao/resolucoes/2012/resolucao-no-466.pdf/view
Resolução nº 510, de 07 de abril de 2016. (2016, 07 de abril). Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais cujos procedimentos metodológicos envolvam a utilização de dados diretamente obtidos com os participantes ou de informações identificáveis ou que possam acarretar riscos maiores do que os existentes na vida cotidiana. Conselho Nacional de Saúde. https://www.gov.br/conselho-nacional-de-saude/pt-br/acesso-a-informacao/legislacao/resolucoes/2016/resolucao-no-510.pdf/view
Singh, G., Rees, J. H., & Sander, J. W. (2007). Seizures and epilepsy in oncological practice: Causes, course, mechanisms and treatment. Journal of Neurology, Neurosurgery, and Psychiatry, 78(4), 342–349. https://doi.org/10.1136/jnnp.2006.106211
Soares, J., & Galvão, T. (2017). Anticoagulação no paciente oncologico. Rev. Soc. Cardiol. Estado de Säo Paulo, 278–281. http://dx.doi.org/10.29381/0103-8559/20172704278-81
Sun, M.-Y., & Bhaskar, S. M. M. (2022). When Two Maladies Meet: Disease Burden and Pathophysiology of Stroke in Cancer. International Journal of Molecular Sciences, 23(24), 15769. https://doi.org/10.3390/ijms232415769
Suzano, A. C. M. (2024). O Câncer Colorretal-CCR. Revista Ibero-Americana de Humanidades, Ciências e Educação, 10(5), Artigo 5. https://doi.org/10.51891/rease.v10i5.13360
Zöller, B., Ji, J., Sundquist, J., & Sundquist, K. (2012). Risk of haemorrhagic and ischaemic stroke in patients with cancer: A nationwide follow-up study from Sweden. European Journal of Cancer (Oxford, England: 1990), 48(12), 1875–1883. https://doi.org/10.1016/j.ejca.2012.01.005
Zuber, M. (2023). Stroke and cancer. Revue Neurologique, 179(5), 417–424. https://doi.org/10.1016/j.neurol.2023.03.009
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Copyright (c) 2024 Danilo dos Santos Silva; Ed Carlos Rey Moura; João Nogueira Neto; Plínio da Cunha Leal; Caio Marcio Barros de Oliveira; Maryane Belshoff de Almeida; Júlia Aguiar Hermisdorf; Jacira do Nascimento Serra; Jardel Cavalcante de Farias
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