Hypocalcemia associated with 5-fluorouracil and low dose leucovorin in patients with advanced colorectal or gastric carcinomas

✍ Scribed by Yuichiro Kido; Takeshi Okamura; Morimasa Tomikawa; Manabu Yamamoto; Morio Shiraishi; Yasuyo Okada; Toshinari Kimura; Keizo Sugimachi

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 367 KB
• Volume: 78
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19961015)78:8<1794::aid-cncr21>3.0.co;2-s

✦ Synopsis

BACKGROUND.

The biochemical modulation of 5-fluorouracil (5-FU) by leucovorin (Lv) has demonstrated significantly increased response rates in comparison with the use of 5-FU alone in patients with advanced colorectal carcinoma. However, the higher response rate of LV/5-FU may occur at the expense of increased toxicity and side effects such as diarrhea, myelosuppression, and mucositis. During chemotherapy, a high incidence of hypocalcemia associated with this chemotherapy regimen was noted. This study was therefore aimed at assessing the side effects of chemotherapy using low dose LV/S-FU on calcium metabolism. METHODS. Twenty-five patients with advanced gastric or colorectal carcinoma were treated with chemotherapy comprised of low dose LV administered at 20 mg/m2/ day by intravenous bolus, followed by l-hour intravenous infusion of 5-FU at 425-600 mg/m' /day for 5 consecutive days every 28 days. RESULTS. The toxic effects were generally mild, and included diarrhea, mucositis, leukopenia, and nausea/vomiting. Fifteen patients (65%) experienced hypocalcemia. The plasma 1,25-(OH)>D3 levels were significantly reduced on Day 5 due to the chemotherapy. CONCLUSIONS. The toxic effects of the regimen were generally mild. However, a high percentage of hypocalcemia occurred with the combination of LV/5-FU. It is therefore necessary to examine carefully the serum calcium levels of patients when using this chemotherapeutic modality.