5-Fluorouracil rechallenge after 5-fluorouracil-induced hyperammonemic encephalopathy.
Anticancer Drugs
; 30(3): 313-317, 2019 03.
Article
em En
| MEDLINE
| ID: mdl-30531368
ABSTRACT
For several decades, 5-Fluorouracil (5-FU) has been the backbone of many chemotherapy regimens for various tumor types. Its most common side effects are gastrointestinal disorders, mucositis, myelosuppression, hand-foot syndrome, and rarely cardiac toxicity. More rarely, 5-FU infusion can induce hyperammonemic encephalopathy. 5-FU toxicities can be worsened by complete or partial genetic and/or phenotypic dihydropyrimidine dehydrogenase deficiency. Here, we report the case of a patient who initially developed a 5-FU-induced hyperammonemic encephalopathy after receiving FOLFIRINOX (oxaliplatin, irinotecan, folinic acid, and 5-FU) chemotherapy with bevacizumab to treat a metastatic gastrointestinal cancer of unknown primary. Thereafter, the patient was rechallenged successfully by the same chemotherapy regimen (FOLFIRINOX) for more than 6 months with a protocol consisting in a free protein diet, and administration of ammonium chelators, and Krebs and urea cycle intermediates, to prevent further hyperammonemia. We also present a review of the literature on 5-FU rechallenge after 5-FU-induced hyperammonemic encephalopathy.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Primárias Desconhecidas
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Encefalopatias
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Protocolos de Quimioterapia Combinada Antineoplásica
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Retratamento
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Hiperamonemia
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Fluoruracila
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Neoplasias Gastrointestinais
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Female
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Humans
Idioma:
En
Revista:
Anticancer Drugs
Assunto da revista:
ANTINEOPLASICOS
Ano de publicação:
2019
Tipo de documento:
Article