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Medline ® Abstracts for References 17,30,115,116

of 'Fluoropyrimidine-associated cardiotoxicity: Incidence, clinical manifestations, mechanisms, and management'

17
TI
Cardiotoxicity of de Gramont's regimen: incidence, clinical characteristics and long-term follow-up.
AU
Meydan N, Kundak I, Yavuzsen T, Oztop I, Barutca S, Yilmaz U, Alakavuklar MN
SO
Jpn J Clin Oncol. 2005 May;35(5):265-70. Epub 2005 Apr 26.
 
BACKGROUND: The incidence of 5-fluorouracil (5-FU)-related cardiotoxicity seems to be dosage and schedule dependent. It was reported as 1.6-3% with earlier bolus regimens whereas this increased up to 7.6-18% with prolonged (4-5 days) infusion regimens. Knowledge of the cardiotoxicity incidence in patients treated with the widely used de Gramont's regimen (2 days infusional 5-FU) and the long-term follow-up of affected patients is still limited.
METHODS: We investigated the incidence and clinical characteristics of the cardiotoxicity of de Gramont's regimen and long-term follow-up of the affected patients.
RESULTS: Nine of a total of 231 patients receiving de Gramont's regimen experienced cardiac events, revealing an overall incidence of 3.9%. Four (2.5%) cases were receiving de Gramont's regimen only. Cardiac manifestations were acute coronary syndrome (n = 6), congestive heart failure (n = 2) and atrial fibrillation (n = 1). Cardiotoxicity occurred in the first cycle in eight patients, and in the second cycle in one. The median onset day was day 2. Cardiac symptoms occurred mostly at night time (seven patients) and the onset was a few hours after the bolus part of the regimen in four out of seven patients. After the cardiotoxicity, treatments were continued safely without 5-FU.
CONCLUSIONS: de Gramont's regimen has a lower incidence of cardiotoxicity compared with more prolonged 5-FU-based infusion regimens. Nevertheless, patients should still be carefully monitored especially in the first cycles and at night time.
AD
Division of Medical Oncology, University of Adnan Menderes, 09100 Aydin, Turkey. nezihmeydan@yahoo.com
PMID
30
TI
The frequency and pattern of cardiotoxicity observed with capecitabine used in conjunction with oxaliplatin in patients treated for advanced colorectal cancer (CRC).
AU
Ng M, Cunningham D, Norman AR
SO
Eur J Cancer. 2005;41(11):1542.
 
We examined the cardiotoxicity in 153 patients treated with capecitabine and oxaliplatin in two prospective trials for advanced colorectal cancer. Ten patients (6.5%) developed cardiac events. One patient (0.7%) had sudden death, one patient developed cardiac failure with raised troponin I while another developed ventricular tachycardia (VT). The remaining seven patients (4.6%) experienced angina and three of the seven patients had raised troponin I, one of which developed ventricular fibrillation. Eight events occurred within cycle 1 (median cycle 1 day 10). Four patients with angina and one patient with VT recovered on stopping capecitabine, four patients required additional medical management and the remaining patient died suddenly at home. Patients with ischaemic heart disease appeared to be at increased risk. Physicians and patients need to be aware of these complications, so that prompt discontinuation of treatment and appropriate interventions may be instituted.
AD
Department of Medicine, Royal Marsden Hospital, Sutton, Surrey, UK.
PMID
115
TI
Raltitrexed (Tomudex): an alternative drug for patients with colorectal cancer and 5-fluorouracil associated cardiotoxicity.
AU
Köhne CH, Thuss-Patience P, Friedrich M, Daniel PT, Kretzschmar A, Benter T, Bauer B, Dietz R, Dörken B
SO
Br J Cancer. 1998 Mar;77(6):973-7.
 
Two patients with proven 5-fluorouracil (5-FU)-associated cardiotoxicity were treated with the specific thymidylate synthase inhibitor raltitrexed safely, without evidence of cardiotoxicity. Raltitrexed might be an alternative for patients with advanced colorectal cancer and 5-FU-associated cardiotoxicity. 5-FU cardiotoxicity is not due to the antineoplastic mechanisms via thymidilate synthase.
AD
Department of Haematology/Oncology and Tumor Immunology Robert-Rössle-Klinik, Virchow-Klinikum, Medizinische Fakultät Charite der Humboldt-Universität zu Berlin, Germany.
PMID
116
TI
The use of raltitrexed (tomudex) in a patient with 5-fluorouracil induced myocardial ischaemia.
AU
Nutting C, Folkes A
SO
Clin Oncol (R Coll Radiol). 1999;11(1):66.
 
AD
PMID