5-Fluorouracil-Related Lactic Acidosis in a Patient with Colon Cancer

Area of Science:

• Oncology
• Gastroenterology
• Pharmacology

Background:

• Colon cancer is a prevalent malignancy often treated with 5-fluorouracil (5-FU) based chemotherapy.
• Lactic acidosis is an uncommon but severe adverse event associated with systemic 5-FU exposure.
• Metastatic colon cancer requires aggressive treatment regimens, increasing the potential for complex side effects.

Purpose of the Study:

• To report a rare case of lactic acidosis in a colon cancer patient treated with mFOLFOX6 and FOLFIRI.
• To highlight the clinical presentation and management of 5-FU-induced lactic acidosis.
• To review existing literature on lactic acidosis following 5-FU chemotherapy in colon cancer patients.

Main Methods:

• Case report of a 36-year-old female patient with metastatic colon cancer.
• Administration of mFOLFOX6 and FOLFIRI chemotherapy regimens.
• Monitoring for adverse events, including metabolic disturbances and neurological symptoms.
• Literature review of similar cases and treatment outcomes.

Main Results:

• The patient developed severe lactic acidosis (lactate level 10 mmol/L) two days post-chemotherapy.
• Clinical manifestations included unconsciousness and convulsions.
• Treatment with sodium bicarbonate led to improvement in consciousness and convulsions.
• Literature review confirmed the rarity but potential severity of this adverse event.

Conclusions:

• Systemic 5-FU chemotherapy can rarely induce severe lactic acidosis in colon cancer patients.
• Prompt recognition and supportive treatment, such as sodium bicarbonate, are crucial for managing this complication.
• Awareness of this potential side effect is important for oncologists managing patients with colon cancer.