5-Fluorouracil cardiotoxicity with left ventricular dysfunction under different dosing regimens

The observations reported here support the hypothesis that 5-FU induces a reversible cardiopathy (having a common final pathway with ischemia), including myocardial dysfunction, with a potentially fatal course. Although a clear dose-response relation is not evident, the incidence seems to be increased with recently promoted 24-hour high-dose 5-FU/ folinic acid combination therapy. There may be a cumulative “threshold dose” of 1,500 to 7,000 mg. To date, predisposing factors as well as a reliable treatment and prophylaxis are not well defined.