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Hypocalcemia associated with 5‐fluorouracil and low dose leucovorin in patients with advanced colorectal or gastric carcinomas
Author(s) -
Kido Yuichiro,
Okamura Takeshi,
Tomikawa Morimasa,
Yamamoto Manabu,
Shiraishi Morio,
Okada Yasuyo,
Kimura Toshinari,
Sugimachi Keizo
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19961015)78:8<1794::aid-cncr21>3.0.co;2-s
Subject(s) - medicine , fluorouracil , gastroenterology , oncology , chemotherapy
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/5‐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/m 2 /day by intravenous bolus, followed by 1‐hour intravenous infusion of 5‐FU at 425–600 mg/m 2 /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) 2 D 3 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. Cancer 1996;78:1794‐7.