[Cardiotoxicity of 5-fluorouracil. Spasm or direct myocardial toxicity?].
The authors report on a case of cardiotoxicity observed during a protocol including a 5-day continuous infusion of 5-fluorouracil; anginal manifestations recurred during a second treatment course. Coronary angiography, thallium scintigraphy and methergine test were all normal. An attempt to prevent the recurrence of such manifestations using a calcium inhibitor and nitroderivatives was unsuccessful. In connection with this case, six other with anginal manifestation and four sudden deaths under the same protocol, a review of the relevant literature is included in the discussion on the factors that may favor cardiotoxicity and the different etiopathogenic hypothesis. The generally accepted hypothesis is a coronary spasm but a direct cardiotoxicity of 5-FU cannot be. The only therapeutic possibility appears to be the definitive halt of 5-FU after the onset of such manifestations.
Thyss
A
A
Service d'Hématologie-Oncologie, Centre Antoine-Lacassagne, Nice, France.
Falewee
M N
MN
Leborgne
L
L
Viens
P
P
Schneider
M
M
Demard
F
F
D000368:Aged; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged
D005472:Fluorouracil
Cardiotoxicité du 5 fluoro-uracile. Spasme ou toxicité myocardique directe?