Oncology Unit, MultiMedica Hospital, Castellanza, VA, USA.
Breast J. 2010 Sep-Oct;16 Suppl 1:S45-8. doi: 10.1111/j.1524-4741.2010.01004.x.
Capecitabine is an orally available fluoropyrimidine carbamate that selectively delivers fluorouracil (5-FU) to tissues expressing high levels of thymidine phosphorylase (TP) such as tumors. The drug has demonstrated efficacy in metastatic breast cancer, colorectal, and pancreatic cancer. Although these are considered safe drugs, a growing body of literature reports adverse cardiac effects. Clinical trials indicate that capecitabine has a cardiac toxicity similar to that of infused fluoropyrimidines such as 5-FU. Here, we review cardiotoxicity in the use of fluoropyrimidines, with particular attention toward capecitabine. We also describe a severe, reversible cardiac event that occurred in a 39-year-old woman, with no cardiac risk factors, treated with capecitabine for advanced breast cancer. This review and our experience confirm that fluoropyrimidine cardiotoxicity is an infrequent but documented side effect. Oncology patients under treatment should be closely observed and monitored for cardiac symptoms with particular attention in case of signs or symptoms of cardiovascular complications. The implementation of cardio-oncology interdisciplinary teams should, in the future, reduce the impact of cancer treatment-associated cardiotoxicity syndromes.
卡培他滨是一种口服氟嘧啶氨基甲酸酯，可选择性地将氟尿嘧啶（5-FU）递送至表达高水平胸苷磷酸化酶（TP）的组织，如肿瘤。该药物已在转移性乳腺癌、结直肠癌和胰腺癌中显示出疗效。尽管这些被认为是安全的药物，但越来越多的文献报告了不良的心脏效应。临床试验表明，卡培他滨的心脏毒性与输注氟嘧啶类药物（如 5-FU）相似。在这里，我们回顾了氟嘧啶类药物的心脏毒性，特别关注卡培他滨。我们还描述了一例发生在一名 39 岁女性身上的严重、可逆性心脏事件，该患者无心脏危险因素，因晚期乳腺癌接受卡培他滨治疗。本综述和我们的经验证实，氟嘧啶类药物的心脏毒性是一种罕见但有记录的副作用。接受治疗的肿瘤患者应密切观察并监测心脏症状，特别是在出现心血管并发症的迹象或症状时。未来，肿瘤心脏病学多学科团队的实施应减少与癌症治疗相关的心脏毒性综合征的影响。
