Prophylactic options in patients with 5-fluorouracil-associated cardiotoxicity.
At present, the various mechanisms involved in 5-fluorouracil (5-FU)-correlated cardiotoxicity remain to be elucidated and a universally accepted prophylaxis or treatment for this specific toxicity is not available. Although it may improve time to progression, survival and clinical benefit, a 5-FU-based regimen usually has to be discontinued if a patient experiences cardiotoxicity. Here, we describe our experience with three cases of 5-FU-associated cardiotoxicity. The angina-like pain that appeared approximately 95 h after beginning 5-FU therapy was apparently independent of the drug's administration modality. In the two patients receiving 5-FU 12-h flat continuous infusion from 22.00 to 10.00 h (5-FU 12-h c.i.) in combination with other drugs, the dose of 5-FU was reduced by 10-20% and patients received prophylactic transepidermal nitroglycerin. In the third patient, 5-FU administration modality was changed and prophylactic therapy was not given. By taking these precautions, the patients no longer complained of anginal pain and none of them discontinued chemotherapy.
Cianci
G
G
Department of Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy.
Morelli
M F
MF
Cannita
K
K
Morese
R
R
Ricevuto
E
E
Di Rocco
Z C
ZC
Porzio
G
G
Lanfiuti Baldi
P
P
Ficorella
C
C
D000368:Aged; D000787:Angina Pectoris / Q000139:chemically induced* / Q000517:prevention & control*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D005996:Nitroglycerin / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000964:Antimetabolites, Antineoplastic; D014665:Vasodilator Agents; D005996:Nitroglycerin; D005472:Fluorouracil