Nerve, muscle and heart acute toxicity following oxaliplatin and capecitabine treatment.
Capecitabine plus oxaliplatin combination (XELOX) is the first-line treatment in metastatic colorectal cancer. Here we report a case of acute, severe but substantially reversible, neuromuscular and cardiac toxicity following XELOX chemotherapy. Muscle biopsy findings were consistent with a toxic myopathy with necrotizing features and vacuolar changes; COX-negative fibers were also present. The time course could support a main role for capecitabine, which may have some neurotoxic effects (more frequently central), but a detrimental interaction between the two drugs cannot be ruled out and further studies are needed.
Department of Neuroscience, Neurological Clinic, University of Pisa, Via Roma 67, 56126 Pisa, Italy. d.orsucci@sssup.it
Daniele
D
Orsucci
Chiara
C
Pizzanelli
Greta
G
Alì
Rosanna
R
Calabrese
Giulia
G
Ricci
Paola
P
Lenzi
Lucia
L
Petrozzi
Policarpo
P
Moretti
Gabriele
G
Siciliano
D000230:Adenocarcinoma / Q000188:drug therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000069287:Capecitabine; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D015179:Colorectal Neoplasms / Q000188:drug therapy; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D009944:Organoplatinum Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D000077150:Oxaliplatin
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil