Severe colitis after administration of UFT chemotherapy for temporal bone carcinoma.
UFT (Uftoral), a blend of uracil and Tegafur, is an antitumour agent for oral administration that is presumed to maintain the concentration of 5-fluorouracil (5-FU) in tumour tissue. As a result of increased use of high-dose 5-FU-based chemotherapy for various solid tumours, complicated drug-induced colitis is more frequently observed. Dihydropyrimidine dehydrogenase (DPD) is the rate-limiting enzyme in the catabolism of 5-FU and its deficiency is responsible for the severe toxicities encountered in cancer patients receiving 5-FU. The authors present the case of a patient with locally advanced temporal bone carcinoma who developed haematochezia during a course of chemotherapy with UFT. Colonoscopy of the patient showed bleeding petechia-like lesions and superficial inflammatory exudate, whilst histology revealed non-specific inflammatory changes of the colon mucosa. As the haematochezia improved with supportive treatment, neutropenia complicated the clinical picture. This patient developed life-threatening UFT toxicity without an exon-14 DPD gene mutation.
Gastroenterology Department, Ege University Medical School Hospital, Bornova, Izmir, Turkey. sinanakay72@yahoo.com
S
S
Akay
O
O
Ozütemiz
B
B
Doganavsargil
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003108:Colonic Diseases / Q000209:etiology*; D003113:Colonoscopy; D004338:Drug Combinations; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000188:drug therapy*; D012888:Skull Neoplasms / Q000188:drug therapy*; D005641:Tegafur / Q000009:adverse effects* / Q000627:therapeutic use; D013701:Temporal Bone; D014498:Uracil / Q000009:adverse effects* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D004338:Drug Combinations; C096910:UFT(R) drug; D005641:Tegafur; D014498:Uracil