STRN of coccyx patient with pulmonary metastatic disease

67 YO female patient with primary colorectal CA treated with surgery, chemotherapy and radiation. Developed coccygeal abscess and subsequent large, non-healing soft tissue defect/ wound due to late effects of radiation. PET scan shows no remaining disease in pelvic/ rectal area.
Has metastatic pulmonary nodules, for which she had been taking Lonsurf with bevacizumab. Colorectal surgeon recommended HBOT and NPWT. Chemotherapy was held when HBOT started on 11/20/2024. Bevacizumab is a VEG-F inhibitor. Patient's 40th treatment would be 1/20/2025. She wants to stop at 40 rather than 60 tx.
Both patient and oncologist wish to restart oral chemotherapy rather than go about 5 more weeks without treating the metastatic disease. Oncologist would restart the Lonsurf without the bevacizumab.

Would there be an issue with the Lonsurf (trifluridine/ tipiracil) with HBOT?

There is improvement in would appearance and size with HBOT plus the NPWT over the last 4 weeks or so.

Dec 17, 2024 by Brenda Megna, BSN RN CHRN

2 replies

Mike White
MD, UHM, MMM, CWS

Brenda,

I did a quick literature search for HBO, trifluridine, and tipiracil and did not come up with any useful information. I would recommend your HBO physician and the Oncologist discuss the risks HBO and this particular drug for this patient. I wish I could be more helpful.

Mike White

Dec 18, 2024

Brenda Megna
BSN RN CHRN

Thank-you. All of the providers involved in this patient's care appreciate the input.

Dec 19, 2024

* Information provided without clinical evaluation and is not intended as a replacement for in-person consultation with a medical professional. The information provided through Curbside Consult is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

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