The spectrum of 5-fluorouracil cardiotoxicity

To report three cases of cardiotoxicity related to the administration of 5-fluorouracil (5-FU) in patients with cancer.

Three patients with gastrointestinal malignancies were being treated with combined radiotherapy and chemotherapy regimens. Two patients developed myocardial ischaemia and the other a ventricular arrhythmia in association with 5-FU administration.

All patients survived the cardiac event. No patient was rechallenged with 5-FU. Radiotherapy was continued, achieving a good tumour response.

Cardiotoxicity is rarely reported with 5-FU. The cardiac events can be life threatening. It is difficult to predict which patients will be affected. Clinicians need to be aware of this potential toxicity and monitor patients appropriately.