Lethal toxicity after 5-fluorouracil chemotherapy and its possible relationship to dihydropyrimidine dehydrogenase deficiency: a case report and review of the literature.
5-fluorouracil (5-FU) is a chemotherapeutic agent widely used in the treatment of solid malignancies, especially in colorectal cancer. A characteristic note seen with its use is the considerable interindividual variation in the incidence and severity of the toxicities seen among patients. We report the case of a 55-year old woman who presented with severe, lethal toxicity to standard doses of 5-fluorouracil (5-FU) and folinic acid. We discuss the known clinical determinants of toxicity. We also discuss the possible molecular factors implicated in the variable toxicity seen to 5-FU, especially in regards to dihiyropyrimidine dehydrogenase, a pivotal enzyme in the metabolism of 5-FU.
Díaz
R
R
Medical Oncology Unit, University Hospital La Fe, Valencia, Spain. rdiazbev@hotmail.com
Segura
A
A
Aparicio
J
J
Calderero
V
V
Guerrero
A
A
Pellín
L
L
D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy*; D003677:Deficiency Diseases / Q000150:complications*; D054067:Dihydropyrimidine Dehydrogenase Deficiency; D017809:Fatal Outcome; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects* / Q000627:therapeutic use*; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged
D000964:Antimetabolites, Antineoplastic; D005492:Folic Acid; D005472:Fluorouracil