Acute development of cardiomyopathy and occlusive thromboembolic events following cisplatin and 5-fluorouracil (5-FU) is rare but frequently lethal. The authors report the successful management of such an event in a 52-year-old man with squamous cell carcinoma of the soft palate. The possible pathophysiological mechanisms are discussed.
Get full access to this article
View all access options for this article.
References
1.
Labianca R., Beretta G., Clerici M., et al: Cardiac toxicity of 5-fluorouracil: A study on 1,083 patients . Tumori68:505-510, 1982.
2.
Robben NC, Pippas AW, Moore JO: The syndrome of 5-fluorouracil cardiotoxicity: An elusive cardiopathy . Cancer71:493-509, 1993.
3.
Patel B., Kloner RA, Ensley J., et al: 5-Fluorouracil cardiotoxicity : Left ventricular dysfunction and effect of coronary vasodilators. Am J Med Sci294:238-243, 1987.
4.
Weidmann B., Jansen W., Heider A., et al: 5-Fluorouracil cardiotoxicity with left ventricular dysfunction under different dosing regimens. Am J Cardiol75:194-195, 1995.
5.
Misset B., Escudier B., Leclercq B., et al: Acute myocardiotoxicity during 5-Fluorouracil therapy. Intensive Care Med16:210-211, 1990.
6.
Sasson Z., Morgan CD, Wang B., et al: 5-Fluorouracil-related toxic myocarditis: Case reports and pathological confirmation. Can J Cardiol10:861-864, 1994.
7.
Porta C., Moroni M., Ferrai S., et al: Endothelin-1 and 5-fluorouracil-induced cardiotoxicity. Neoplasma45: 81-82, 1998.
8.
Celik I., Kars A., Ozyar E., et al: Major toxicity of cisplatin, fluorouracil and leukovorin following chemoradiotherapy in patients with nasopharyngeal carcinoma. J Clin Oncol14:1043-1044, 1996.
9.
Berger C., Chapet S., Reynaud-Bougnoux A., et al: Enhanced acute toxicity in oropharynx carcinoma treated with radiotherapy and concomitant cisplatin, 5-fluorouracil and mitomycin C. Eur J Cancer32: 1707-1711, 1996 .
10.
Brillet G., Deray G., Baumelou A., et al: Acute cardiac and renal failure after 5-FU and cisplatin treatment . Nephron59:667-668, 1991.
11.
Tomirotti M. , Riundi R., Pulici S., et al: Ischemic cardiopathy from cis-diamminedichloroplatinum (CDDP). Tumori70:235-236, 1984.
12.
Berliner S. , Rahima M., Sidi Y., et al: Acute coronary events following cisplatin-based chemotherapy. Cancer Invest8:383-386, 1990.
13.
Ficli I., Handan K., Dilek D., et al: Severe vascular toxicity associated with cisplatin-based chemotherapy . Cancer72:587-593, 1993.
14.
Allerton R. : Acute mesenteric ischemia associated with 5-FU, cisplatin, vincristine chemotherapy. Clin Oncol8:116-117, 1996.
15.
Eskilsson J. , Albertsson M., Mercke C.: Adverse cardiac effects during induction chemotherapy treatment with cisplatin and 5-fluorouracil . Radiother Oncol13:41-46, 1988.
16.
Jeremic B., Jevremovic S., Djuric L., et al: Cardiotoxicity during chemotherapy with 5-fluorouracil and cisplatin . J Chemother2:264-267, 1990.
17.
Pottage A., Holt S., Ludgate S., et al: Fluorouracil cardiotoxicity. Br Med J1:547, 1978.
18.
Jakubowski A. , Kemeny N.: Hypotension as a manifestation of cardiotoxicity in three patients receiving cisplatin and 5-fluorouracil . Cancer62:266-269, 1988.
19.
Martin M., Diaz-Rubio E., Furio V., et al: Lethal cardiac toxicity after cisplatin and 5-fluorouracil chemotherapy . Am J Clin Oncol12:229-234, 1989.
20.
Meitzer R., Visser C., Fuster V.: Intracardiac thrombi and systemic embolization. Ann Intern Med104: 689-698, 1986.
21.
Wllensky R. , Jung S.: Thromboembolism in patients with decreased left ventricular function: Incidence, risk, treatment. J Cardiovasc Risk2:91-96, 1995.
22.
Stratton J. , Resnick A.: Increased embolic risk in patients with left ventricular thrombi. Circulation75: 1004-1011, 1987.
23.
Arvan S.: Persistent intracardiac thrombi and systemic embolization despite anticoagulation therapy. Am Heart J109:178-181, 1985.
24.
Baerlocher G., Beer J., Owen G., et al: The antineoplastic drug 5-fluorouracil produces echinocytosis and affects blood rheology. Br J Haematol99 :426-432, 1997.
25.
Cwikiel M., Persson S., Larsson H., et al: Changes in blood viscosity in patients treated with 5-fluorouracil—a link to cardiotoxicity? Acta Oncol34 :83-85, 1995.