title: Fluorouracil-based chemotherapy in patients with gastrointestinal malignancies: influence of nutritional folate status on toxicity.
abstract: This study aimed to prospectively evaluate the potential influence of folate status on the toxicity induced by 5-fluorouracil (5-FU)-based chemotherapy in patients with gastrointestinal tumors. 105 patients with colorectal, pancreatic or gastric cancer were entered into the study. Treatment regimens consisted of bolus 5-FU/leucovorin or infusional 5-FU combined with cisplatin. Baseline homocysteine, vitamin B(12) and folic acid serum levels were determined in all patients. Univariate and multivariate logistic regression models were used to identify predictive factors for toxicity. Univariate analysis showed a significant association between older age, low BSA, gastric/pancreatic cancer and treatment with 5-FU/cisplatin and the incidence of grade 3-4 hematological toxicity, and between female sex, low BSA and gastric/pancreatic cancer and the incidence of severe non-hematological toxicity. Variables that retained independent prognostic value in the multivariate model were tumor type, chemotherapy schedule and BSA for both hematological and non-hematological toxicities. Baseline homocysteine, vitamin B(12) or folate status were not significant predictors of any kind of toxicity either according to univariate or multivariate analysis. This study failed to demonstrate a significant association between a patient s nutritional folate status and the toxicity induced by fluoropyrimidine-based chemotherapy in a cohort of patients with various gastrointestinal malignancies.
authors.affiliation: Department of Medical Oncology, Hospital Severo Ochoa, Madrid, Spain. rgcarbonero@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Alvarez-Cabellos
authors.forename: R
authors.initials: R
authors.lastname: Garcia-Carbonero
authors.forename: C
authors.initials: C
authors.lastname: Garcia-Lacalle
authors.forename: P
authors.initials: P
authors.lastname: Gomez
authors.forename: A
authors.initials: A
authors.lastname: Tercero
authors.forename: D
authors.initials: D
authors.lastname: Sanchez
authors.forename: L
authors.initials: L
authors.lastname: Paz-Ares
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects*; D005492:Folic Acid / Q000097:blood*; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D014805:Vitamin B 12 / Q000097:blood / Q000378:metabolism
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12; D002945:Cisplatin; D005472:Fluorouracil