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[Cardiotoxicity of 5-fluorouracil]

Luis Teixeira1, Sonia Barry, Philippe Debourdeau

  • 1Service de Médecine Interne et Oncologie Médicale, Hôpital Saint-Antoine, Paris, 184, rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12.

Bulletin Du Cancer
|May 19, 2005
PubMed

Insights

5-fluorouracil (5FU) chemotherapy can cause cardiotoxicity, presenting as chest pain or heart failure, though typically not life-threatening. Treatment involves stopping 5FU and supportive cardiac care, with most patients having a good prognosis.

Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Context:

  • 5-fluorouracil (5FU) is a widely used antimetabolite chemotherapy agent.
  • While known for toxicities like mucositis and leucopenia, 5FU-induced cardiotoxicity is less common but significant.

Purpose:

  • To review the incidence, clinical presentation, pathophysiology, and management of 5-fluorouracil cardiotoxicity.
  • To highlight the importance of recognizing and managing cardiac adverse events associated with 5FU treatment.

Summary:

  • 5FU cardiotoxicity occurs in 1.5-18% of patients, with symptoms including chest pain, arrhythmias, myocardial infarction, and heart failure.
  • Pathophysiology is debated, but myocardial toxicity is suggested; electrocardiographic findings are often nonspecific ischemic signs.
  • Management involves discontinuing 5FU infusion and initiating symptomatic cardiologic treatment.

Impact:

  • Understanding 5FU cardiotoxicity aids in early diagnosis and appropriate patient management.
  • Despite a generally good prognosis, symptomatic cardiotoxicity carries a mortality risk of 2.2-13%.
  • Further research is needed regarding secondary prophylaxis for 5FU-induced cardiotoxicity.

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