Bolus 5-Fluorouracil as an alternative modality to infusion 5-Fluorouracil in a patient with rectal cancer and capecitabine-induced cardiotoxicity.
5-Fluorouracil (5-FU) is the backbone of the chemotherapy regimens approved for treatment of colorectal cancer. Incidence of cardiotoxicity associated with 5-FU ranges between 1.5% to 18%; 48% as anginal symptoms and 2% as cardiogenic shock. Cardiotoxicity is unpredictable and no alternatives have been defined so far. A 35-year-old man treated for stage III A rectal cancer developed chest pain typical of angina on treatment with capecetabine initially and 5-FU infusion afterwards. Scheduled dosing of 5-FU was changed from infusion to a bolus type. He was asymptomatic with no electrocardiographic (ECG) changes on 24-h Holter monitoring after changing the mode of administration to bolus 5-FU. Here, we report the first case in the English literature where a change in the mode of 5-FU administration to bolus is an alternative to infusion 5-FU-induced cardiotoxicity. In conclusion, Bolus 5-FU can be used in patients developing cardio-toxicity due to 5-FU infusion.
Shaib
Walid
W
Hospital of Saint Raphael, New Haven, CT, USA.
Lee
Veronica
V
Saif
M Wasif
MW
D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D000069287:Capecitabine; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D006331:Heart Diseases / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil