Severe rhabdomyolysis related to oxaliplatin adjuvant therapy for colorectal cancer

BMJ Case Rep. 2019 Apr 16;12(4):e228673. doi: 10.1136/bcr-2018-228673.

Abstract

Colorectal cancer is the third most common cancer in men and the second in women. The standard chemotherapy regiment in stage III colon cancer is based in oxaliplatin. The most common side effects include neutropenia, peripheral neuropathy, vomiting and diarrhoea. Rhabdomyolysis due to oxaliplatin is rare, and there are no established guidelines for managing this adverse event. This report describes a case of a 52-year-old man, with a resected stage III colon cancer that started postoperative adjuvant chemotherapy with capecitabine plus oxaliplatin. After the second cycle, the patient developed distal muscle pain and weakness, with a total inability to walk. Blood tests showed an elevated creatine kinase and renal injury. Severe drug-related rhabdomyolysis was diagnosed. The goal of this case report is to discuss the side effect of adjuvant chemotherapy, given its rarity and severity.

Keywords: cancer intervention; chemotherapy; colon cancer; musculoskeletal and joint disorders; unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols*
  • Capecitabine / administration & dosage*
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms / drug therapy*
  • Disease-Free Survival
  • Humans
  • Male
  • Middle Aged
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / adverse effects*
  • Rhabdomyolysis / chemically induced*
  • Rhabdomyolysis / drug therapy
  • Rhabdomyolysis / physiopathology
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Oxaliplatin
  • Capecitabine