First Department of Medicine, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
Oncol Res Treat. 2018;41(1-2):52-56. doi: 10.1159/000480661. Epub 2018 Jan 22.
Oxaliplatin is a platinum-based antineoplastic agent used for the treatment of colorectal cancer and other gastrointestinal tumors. In combination with 5-fluorouracil for instance it is given in the so-called FOLFOX regimen in patients with colorectal cancer in the adjuvant as well as the palliative treatment setting. Cumulative neuropathy is a common cause of treatment discontinuation. Other toxicities are generally tolerable and managed by dose reductions and/or supportive treatment. While chronic cardiotoxic effects of cytostatics are well described, there are few reports on acute cardiotoxic reactions.
The present case describes the sudden development of a transient coronary vasospasm in a 56-year-old male patient mimicking an acute ST segment elevation myocardial infarction during systemic treatment with oxaliplatin.
Oxaliplatin is one of the most commonly used cytostatics for gastrointestinal cancer. Coronary vasospasm has never been reported for oxaliplatin. Thus it is crucial to keep in mind that acute cardiotoxic side effects may occur, even with chemotherapeutic agents without a prior evidence-based description of such events.
奥沙利铂是一种铂类抗肿瘤药物，用于治疗结直肠癌和其他胃肠道肿瘤。例如，与氟尿嘧啶联合使用时，奥沙利铂可用于结直肠癌患者的辅助治疗和姑息治疗，采用的方案称为 FOLFOX 方案。累积性神经病变是导致治疗中断的常见原因。其他毒性通常是可以耐受的，并通过减少剂量和/或支持性治疗来管理。虽然细胞毒性药物的慢性心脏毒性作用已有详细描述，但急性心脏毒性反应的报道很少。
本病例描述了一名 56 岁男性患者在接受奥沙利铂全身治疗期间，突然出现短暂性冠状动脉痉挛，类似于急性 ST 段抬高型心肌梗死。
奥沙利铂是胃肠道癌最常用的细胞毒性药物之一。奥沙利铂从未报道过冠状动脉痉挛。因此，必须牢记，即使是没有此类事件的循证描述的化疗药物，也可能会发生急性心脏毒性副作用。
