Acute pericarditis during 5-fluorouracil, docetaxel and cisplatin therapy

DCF chemotherapy regimen includes docetaxel, cisplatin, and 5-fluorouracil (5-FU). Cardiotoxicity is one of the well-known side effects of 5-FU, docetaxel, and cisplatin. In addition, the complications and side effects are more apparent when these three agents are given in combination. For the first time we describe a case of acute pericarditis associated with DCF regimen in a male patient. A 55-year-old man recently diagnosed with syncrone nasopharenx and non-small cell lung carcinoma was admitted to the oncology unit for chemotherapy. On the fourth day of infusion therapy with DCF he developed a central chest pain that was in pleuritic character and aggravated by recumbence. On electrocardiography (ECG), there was ST elevation on V2-6, D1, D2, and AVL. The patient was immediately transported to the cardiac catheterization laboratory for primary percutaneous coronary intervention. On coronary angiography, coronary arteries were normal. There was no segmentary wall motion abnormality on left ventricle in transthoracic echocardiography. The patient was diagnosed with acute pericarditis and the DCF regimen was discontinued. After 3 days, chest pain disappeared and ECG was normalized. According to the present case, the management of DCF-induced pericarditis includes stopping the drug and administering supportive treatment. The best method to prevent recurrent pericarditis induced by DCF is to use an alternate chemotherapeutic regimen.