Management of side effects of 5-FU based chemotherapy

Kwon, Sung Joon

REVIEW

Korean J Clin Oncol. 2005;1(1): 51-58.

Management of side effects of 5-FU based chemotherapy

Sung Joon Kwon

Department of Surgery, College of Medicine, Hanyang University, Seoul, Korea

5-FU를 이용한 항암요법에 따른 부작용 관리

권성준

한양대학교 의과대학 외과학교실

Corresponding Author: Sung Joon Kwon ,Tel: 82-2-2990-8453, Fax: 82-2-2281-0224, Email: sjkwon@hanyang.ac.kr

Received: May 10, 2005; Accepted: June 20, 2005.

ABSTRACT

The antimetabolite 5-fluorouracil (5-FU) has been reported to cause several kinds of side effects. 5-FU-induced nausea and vomiting remain two of patients1 most feared effects of cancer treatment. The incidence and severity of nausea or vomiting varies depending on dose, schedule, combination of medications, and individual characteristics. Epithelial ulcera¬tion may occur throughout the gastrointestinal tract and may manifest as mucositis, pharyngitis, esophagitis, gastritis, colitis, or proctitis. Continuous intravenous infusion of 5-FU increases the risk of oral mucositis and diarrhea, especially if combined with leucovorin. Severe myelosuppression which is a major cause of morbidity and mortality in cancer patients and dose-limiting for many types of chemotherapy occurs infrequently with usual dose of 5-FU. Fortunately, several selective 5 HT3 antagonists and corticosteroids are commercially available which are important approaches to controlling 5-FU-induced emesis. Colony stimulating factors are used to augment bone marrow production of PMNs. Development of supportive care reduced the incidence and severity of 5-FU-induced toxicity and let the maintenance of dose intensity at the scheduled time. In this review, the side effect induced by 5-FU based chemotherapy including nausea and vomiting, myelosuppression, and neuro-cardio-cutaneous toxicities are discussed.

Keywords: Chemotherapy | 5-FU | Side effect