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5-FU-induced cardiac toxicity - an underestimated problem in radiooncology?

BACKGROUND: 5-Fluorouracil (5-FU) is an antimetabolite, which is frequently used as chemotherapeutic agent for combined chemoradiotherapy. The purpose of this study was to present the clinical course of three patients who developed severe cardiac toxicity by 5-FU and to give a review of the literatu...

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Autores principales: Steger, Felix, Hautmann, Matthias G, Kölbl, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551828/
https://www.ncbi.nlm.nih.gov/pubmed/23241239
http://dx.doi.org/10.1186/1748-717X-7-212
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author Steger, Felix
Hautmann, Matthias G
Kölbl, Oliver
author_facet Steger, Felix
Hautmann, Matthias G
Kölbl, Oliver
author_sort Steger, Felix
collection PubMed
description BACKGROUND: 5-Fluorouracil (5-FU) is an antimetabolite, which is frequently used as chemotherapeutic agent for combined chemoradiotherapy. The purpose of this study was to present the clinical course of three patients who developed severe cardiac toxicity by 5-FU and to give a review of the literature on the cardiotoxic potential of 5-FU. RESULTS: Cardiotoxicity is a rare, but relevant side effect of fluoropyrimidines. It comprehends a wide spectrum of side effects, from electrocardiogram changes (69% of cardiac events) to myocardial infarction (22%) and cardiogenic shock (1%). In this case series three patients with cardiotoxic events during chemoradiotherapy including 5-FU, the reaction's characteristics and their influence on further therapy are described. Two of the patients could not be treated with 5-FU any more because they had developed a myocardial ischemia, which was most likely caused by fluorouracil. Another patient, who complained about typical angina pectoris during 5-FU-infusion and had a new left anterior hemiblock, was reexposed with prophylactic administration of nitrendipine. CONCLUSION: Cardiotoxicity caused by 5-FU is an underestimated problem in radiooncology. Especially patients without history of cardiac disease are often treated as out-patients and therefore without cardiac monitoring. Consequently asymptomatic and symptomatic cardiac events may be overlooked. The benefit of prophylactic agents remains unclear, so close cardiac monitoring is the most established method to prevent manifest cardiotoxic events.
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spelling pubmed-35518282013-01-24 5-FU-induced cardiac toxicity - an underestimated problem in radiooncology? Steger, Felix Hautmann, Matthias G Kölbl, Oliver Radiat Oncol Case Report BACKGROUND: 5-Fluorouracil (5-FU) is an antimetabolite, which is frequently used as chemotherapeutic agent for combined chemoradiotherapy. The purpose of this study was to present the clinical course of three patients who developed severe cardiac toxicity by 5-FU and to give a review of the literature on the cardiotoxic potential of 5-FU. RESULTS: Cardiotoxicity is a rare, but relevant side effect of fluoropyrimidines. It comprehends a wide spectrum of side effects, from electrocardiogram changes (69% of cardiac events) to myocardial infarction (22%) and cardiogenic shock (1%). In this case series three patients with cardiotoxic events during chemoradiotherapy including 5-FU, the reaction's characteristics and their influence on further therapy are described. Two of the patients could not be treated with 5-FU any more because they had developed a myocardial ischemia, which was most likely caused by fluorouracil. Another patient, who complained about typical angina pectoris during 5-FU-infusion and had a new left anterior hemiblock, was reexposed with prophylactic administration of nitrendipine. CONCLUSION: Cardiotoxicity caused by 5-FU is an underestimated problem in radiooncology. Especially patients without history of cardiac disease are often treated as out-patients and therefore without cardiac monitoring. Consequently asymptomatic and symptomatic cardiac events may be overlooked. The benefit of prophylactic agents remains unclear, so close cardiac monitoring is the most established method to prevent manifest cardiotoxic events. BioMed Central 2012-12-15 /pmc/articles/PMC3551828/ /pubmed/23241239 http://dx.doi.org/10.1186/1748-717X-7-212 Text en Copyright ©2012 Steger et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Steger, Felix
Hautmann, Matthias G
Kölbl, Oliver
5-FU-induced cardiac toxicity - an underestimated problem in radiooncology?
title 5-FU-induced cardiac toxicity - an underestimated problem in radiooncology?
title_full 5-FU-induced cardiac toxicity - an underestimated problem in radiooncology?
title_fullStr 5-FU-induced cardiac toxicity - an underestimated problem in radiooncology?
title_full_unstemmed 5-FU-induced cardiac toxicity - an underestimated problem in radiooncology?
title_short 5-FU-induced cardiac toxicity - an underestimated problem in radiooncology?
title_sort 5-fu-induced cardiac toxicity - an underestimated problem in radiooncology?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551828/
https://www.ncbi.nlm.nih.gov/pubmed/23241239
http://dx.doi.org/10.1186/1748-717X-7-212
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