[Four Cases of Gastrointestinal Perforation Associated with Bevacizumab]

Four cases of gastrointestinal perforation associated with bevacizumab(BEV)were examined. Case 1: A 82-year-old male received FOLFIRI plus BEV for recurrent liver metastasis after rectal cancer resection. A lower esophageal perforation occurred 22 days after BEV administration and drainage was performed. Case 2: A 69-year-old female received FOLFOX4 plus BEV for unresectable rectal cancer and liver and lung metastasis. A rectal perforation occurred 6 days after BEV administration and suturing closure of the hole and colostomy was performed. Case 3: A 69-year-old female, received carboplatin(CBDCA) plus pemetrexed(PEM)plus BEV for unresectable left lung cancer and adrenal gland and lymph node metastasis. A small intestinal perforation occurred 15 days after BEV administration and ileocecal resection and primary anastomosis was performed. Case 4: A 73-year-old female received CBDCA plus PEM plus BEV for unresectable left lung carcinoma and pleural metastasis. A diverticulum of sigmoid colon perforation occurred 30 days after BEV administration and suturing closure of the hole and colostomy was performed. When we observe fever, abdominal pain, elevation of the inflammatory reaction after BEV administration, we should immediately examine gastrointestinal perforation.